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The usefulness of telemedicine devices in patients with severe heart failure with an implanted cardiac resynchronization therapy system during two years of observation
Affiliations- 1st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology and Heart Failure, S School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
- Department of Neurology, Professor Leszek Giec, Upper-Silesian Heart Center, Medical University of Silesia, Katowice, Poland
- Telemedycyna Polska SA, Poland
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Abstract
Background: Heart failure (HF) remains a disease with a 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 aged 66.1 (11) years, with left ventricular ejection fraction (LVEF) 26.3 (6.8)% underwent cardiac resynchronization therapy (CRT) implantation. They were randomly allocated to the control (standard medical care) or study (standard medical care + telemonitoring device) groups. During the follow-up (24 months), the patients in the study group provided body mass and blood pressure, along with electrocardiogram on a daily basis. The data were transferred to the monitoring center and consulted with a cardiologist. Transthoracic echocardiography and a 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 hospitalization) occurred in 21 patients, more often in the control group (46.8% vs. 21.4%; P = 0.026). In univariate analysis: the use of telemetry (hazard ratio [HR], 0.2; 95% confidence interval [CI], 0.07–0.7; P = 0.004), the presence 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 to the occurrence of the composite endpoint.
Conclusions: The use of a telemonitoring device in CRT recipients improved the prognosis in 2-year observation and contributed to the reduction of HF hospitalization.
Abstract
Background: Heart failure (HF) remains a disease with a 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 aged 66.1 (11) years, with left ventricular ejection fraction (LVEF) 26.3 (6.8)% underwent cardiac resynchronization therapy (CRT) implantation. They were randomly allocated to the control (standard medical care) or study (standard medical care + telemonitoring device) groups. During the follow-up (24 months), the patients in the study group provided body mass and blood pressure, along with electrocardiogram on a daily basis. The data were transferred to the monitoring center and consulted with a cardiologist. Transthoracic echocardiography and a 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 hospitalization) occurred in 21 patients, more often in the control group (46.8% vs. 21.4%; P = 0.026). In univariate analysis: the use of telemetry (hazard ratio [HR], 0.2; 95% confidence interval [CI], 0.07–0.7; P = 0.004), the presence 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 to the occurrence of the composite endpoint.
Conclusions: The use of a telemonitoring device in CRT recipients improved the prognosis in 2-year observation and contributed to the reduction of HF hospitalization.
Keywords
cardiac resynchronization therapy, COVID-19, heart failure, telemedicine
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About this articleTitle
The usefulness of telemedicine devices in patients with severe heart failure with an implanted cardiac resynchronization therapy system during two years of observation
Journal
Kardiologia Polska (Polish Heart Journal)
Issue
Article type
Original article
Pages
41-48
Published online
2021-12-09
Page views
4708
Article views/downloads
863
DOI
10.33963/KP.a2021.0175
Pubmed
Bibliographic record
Kardiol Pol 2022;80(1):41-48.
Keywords
cardiac resynchronization therapy
COVID-19
heart failure
telemedicine
Authors
Marcin Wita
Michał Orszulak
Krzysztof Szydło
Wojciech Wróbel
Artur Filipecki
Karolina Simionescu
Karol Sanecki
Urszula Uchwat
Maciej Wybraniec
Zbigniew Tabor
Krzysztof Gołba
Krystian Wita
Katarzyna Mizia-Stec
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