Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 26, 2019
Date Accepted: May 7, 2019
Remote monitoring improves survival in patients with cardiac resynchronization therapy
ABSTRACT
Background:
Remote monitoring is an established, guideline-recommended technology with unequivocal clinical benefits; however, its ability to improve survival is contradictory.
Objective:
The aim of our study was to investigate the effects of remote monitoring on mortality in an optimally treated heart failure patient population undergoing CRT-D implantation in a large-volume tertiary referral centre.
Methods:
The population of this single-centre, retrospective, observational study included 231 consecutive patients receiving CRT-D devices in the Medical Centre of the Hungarian Defence Forces (Budapest, Hungary) from January 2011 to June 2016. Clinical outcomes were compared between patients on remote monitoring and on conventional follow-up.
Results:
The average follow-up time was 28.4 ± 18.1 months. Patients on remote monitoring suffered more likely from atrial fibrillation, received heart failure management at our dedicated heart failure outpatient clinic more often, and had a slightly lower NYHA functional class. Crude all-cause mortality of remote-monitored patients was significantly lower compared to patients followed conventionally (HR: 0.368, 95% CI: 0.186-0.727, p=0.004). The survival benefit remained statistically significant after adjustment for important baseline parameters (adjusted HR: 0.361, 95% CI: 0.181-0.722, p=0.004)
Conclusions:
In this current single-centre, retrospective study of optimally treated heart failure patients undergoing CRT-D implantation, the use of remote monitoring systems was associated with significantly better survival.
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