The usefulness of telemedicine devices in patients with severe heart failure with an implanted cardiac resynchronization therapy system during two years of observation

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.

Automated summary

This study aimed to investigate the clinical relevance of non-invasive telemonitoring devices in heart failure (HF) patients. The results showed that the use of telemonitoring devices in HF patients undergoing cardiac resynchronization therapy (CRT) improved prognosis and contributed to a reduction in HF hospitalization during the two-year observation period. Factors such as the use of telemetry, the presence of coronary heart disease, hypertension, and patient's body mass were found to be related to the occurrence of the composite endpoint.