A link to better care: The effect of remote monitoring on long-term adverse cardiac events in a propensity score-matched cohort

Abstract

Aims: There are conflicting data regarding the clinical benefits of device-based remote monitoring (RM). We sought to assess the effect of device-based RM on long-term clinical outcomes in recipients of implantable cardioverter-defibrillators (ICDs). Methods: We assessed the incidence of adverse cardiac events, overall mortality and device therapy efficacy and safety in a propensity score-matched cohort of patients under RM compared to patients under conventional follow-up. Data on hospitalizations, mortality and cause of death were systematically assessed using a nationwide healthcare platform. The primary outcome was time to a composite outcome of first hospital admission for heart failure or cardiovascular death. Results: Of a total of 923 implantable device recipients, 164 matched patients were identified (84 under RM, 84 under conventional follow-up). The mean follow-up was 44 months (range 1-123). There were no significant differences regarding baseline characteristics in the matched cohorts. Patients under RM had a significantly lower incidence of the primary outcome (hazard ratio [HR] 2174-2049Document downloaded from http://www.elsevier.es, day 24/05/2017. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. G. Portugal et al. Conclusion:In a propensity score-matched cohort of ICD recipients with long-term follow-up, RM was associated with a lower rate of a combined endpoint of hospital admission for heart failure or cardiovascular death. © 2017 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. All rights reserved. (HR 0,53; IC 0,04; p=0,066). Não se observaram diferenças entre grupos relativamente a terapêuticas apropriadas (MR versus seguimento convencional; 8,1 versus 8,2%, p=NS) ou terapêuticas inapropriadas (6,8 versus 5,0%, p=NS). Conclusão: Numa amostra emparelhada por propensity score de portadores de CDI, a MR associou-se a uma menor incidência de um evento composto de internamento por IC ou morte cardiovascular a longo prazo. PALAVRAS-CHAVE

Lockdown measures for COVID-19 outbreak and variation in physical activity in patients with heart failure and cardiac implantable devices

“…Temporal changes in physiological parameters may precede signs and symptoms of worsening HF [ 14 ] allowing the health team to anticipate preventive measures, and to generate predictive models that can identify patients who are at high or low risk of clinical events [ 15 ]. Several studies have proved the utility of RM in the reduction of mortality in patients with CIED́s [ [16] , [17] , [18] ]. This can lead to a comprehensive approach in which knowledge of the patient's physiological status can anticipate therapeutic measures in order to avoid or minimize decompensation of HF.…”

Remote Care Assistance in Emergency Department Based on Smart Medical

“…The clustering algorithm is to define a dissimilarity measurement method for specific data sets according to one's own judgment and then cluster according to the principle of nearest neighbor [ 22 ]. The objective function of clustering is a function of the set of objects and clustering categories, which can transform the process of clustering into a problem of finding the optimal solution of the objective function, which has a certain universality [ 23 ]. The following formula holds: …”

Validation of a Heart Failure Risk Score in a Cohort of Cardiac Resynchronization Therapy Patients Under Remote Monitoring: Results from the TriageHF™ Algorithm

“… 1 , 6 , 12 The Implant-based Multiparameter Telemonitoring of Patients with Heart Failure trial showed improved clinical outcomes for HF patients with CIEDs, leading to the inclusion of a multiparameter telemonitoring approach in the European Society of Cardiology HF guidelines. 4 , 11 , 16 …”