Implant-based multi-parameter telemonitoring of patients with heart failure and a defibrillator with vs. without cardiac resynchronization therapy option: a subanalysis ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-03-14

AUTHORS

Johann Christoph Geller, Thorsten Lewalter, Niels Eske Bruun, Milos Taborsky, Frank Bode, Jens Cosedis Nielsen, Christoph Stellbrink, Steffen Schön, Holger Mühling, Hanno Oswald, Sebastian Reif, Stefan Kääb, Peter Illes, Jochen Proff, Nikolaos Dagres, Gerhard Hindricks, For the IN-TIME Study Group

ABSTRACT

AIMS: In the IN-TIME trial, automatic daily implant-based multiparameter telemonitoring significantly improved clinical outcomes in patients with chronic systolic heart failure and implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D). We compared IN-TIME results for ICD and CRT-D subgroups. METHODS: Patients with LVEF ≤ 35%, NYHA class II/III, optimized drug treatment, no permanent atrial fibrillation, and a dual-chamber ICD (n = 274) or CRT-D (n = 390) were randomized 1:1 to telemonitoring or no telemonitoring for 12 months. Primary outcome measure was a composite clinical score, classified as worsened if the patient died or had heart failure-related hospitalization, worse NYHA class, or a worse self-reported overall condition. RESULTS: The prevalence of worsened score at study end was higher in CRT-D than ICD patients (26.4% vs. 18.2%; P = 0.014), as was mortality (7.4% vs. 4.1%; P = 0.069). With telemonitoring, odds ratios (OR) for worsened score and hazard ratios (HR) for mortality were similar in the ICD [OR = 0.55 (P = 0.058), HR = 0.39 (P = 0.17)] and CRT-D [OR = 0.68 (P = 0.10), HR = 0.35 (P = 0.018)] subgroups (insignificant interaction, P = 0.58-0.91). CONCLUSION: Daily multiparameter telemonitoring has a potential to reduce clinical endpoints in patients with chronic systolic heart failure both in ICD and CRT-D subgroups. The absolute benefit seems to be higher in higher-risk populations with worse prognosis. More... »

PAGES

1-11

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00392-019-01447-5

DOI

http://dx.doi.org/10.1007/s00392-019-01447-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112764115

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30874886


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