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Usefulness of telemedicine devices in patients with severe heart failure with implanted cardiac resynchronisation therapy system during two years of observation.

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BACKGROUND Heart failure (HF) remains a disease with poor prognosis. Telemonitoring is a medical service aimed at remote monitoring of patients. AIM The study aimed to identify the clinical relevance… Click to show full abstract

BACKGROUND Heart failure (HF) remains a disease with poor prognosis. Telemonitoring is a medical service aimed at remote monitoring of patients. AIM The study aimed to identify the clinical relevance of non-invasive telemonitoring devices in HF patients. METHODS Sixty patients 66.1 (11) years, left ventricular ejection fraction (LVEF) 26.3 (6.8)% underwent cardiac resynchronisation therapy (CRT) implantation. They were randomly allocated to the control (standard medical care) or study (standard medical care + telemonitoring device) group. During follow‑up (24 months) the patients' physiological data (body mass, blood pressure, electrocardiogram) were provided by patients in the study group on a daily basis. The data were transferred to themonitoring centre and consulted by cardiologist. Transthoracic echocardiography and 6‑minute walk test were performed before and 24 months after CRT implantation. RESULTS During the two-year observation, the composite endpoint (death or HF hospitalisation) occurred in 21 patients, more often in the control group (46.8% vs. 21.4%; P<0.03). Inunivariate analysis: the use of telemetry (hazard ratio [HR], 0.2; 95% confidence interval [CI], 0.07-0.7; P=0.004), thepresence of coronary heart disease (HR, 41.4; 95% CI, 3.1-567.7; P=0.005), hypertension (HR, 0.24; 95% CI, 0.07-0.90; P = 0.035) and patient's body mass (HR, 0.36; 95% CI, 0.14-0.92; P = 0.03) were related with the occurrence of the composite endpoint. CONCLUSIONS The use of a telemonitoring device in CRT recipients improved theprognosis in2-year observation and contributed to the reduction of HF hospitalisation.

Keywords: heart; resynchronisation therapy; cardiac resynchronisation; devices patients; heart failure

Journal Title: Kardiologia polska
Year Published: 2021

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