Fluid status telemedicine alerts for heart failure: a randomized controlled trial

Abstract

Among ICD patients with advanced HF, fluid status telemedicine alerts did not significantly improve outcomes. Adherence to treatment protocols by physicians and patients might be challenge for further developments in the telemedicine field.

Disease Management Programs in Cardiology

“…The benefits of this type of patientcentered intervention involving human beings rather than machines have already been particularly well documented in heart failure and stand in striking contrast to a number of different attempts to find a technological alternative that can deliver the same benefits in heart failure. [9][10][11][12] The present report extends the evidence for home-based intervention to other cardiovascular problems, although, in truth, this is hardly surprising given that few patients have heart failure, atrial fibrillation, or coronary heart disease in isolation, and many have all together and usually more problems as well. As always, innovative clinical research like this raises more questions.…”

Simulated case management of home telemonitoring to assess the impact of different alert algorithms on work-load and clinical decisions

“…The data and the alert needs to be designed in a manner which supports the decision making process of the clinician. Perhaps the lack of benefit in recent studies using advanced alerts from impedance measurements done with implanted cardiac devices [31, 32] might, in part, be attributed to the difficulty of interpreting the output measure and guide intervention.…”

Use and Disuse of Observational Research: The Case of Remote Monitoring in Heart Failure

“…The OptiLink HF trial (Optimization of HF Management using OptiVol™ Fluid Status Monitoring and CareLink™) was a prospective, multicenter, randomized unblinded study conducted in Germany, aimed to evaluate whether early automated fluid status alert notification via telemedicine improves outcome in symptomatic HF patients with left ventricular ejection fraction ≤35% fulfilling 1 of 3 other conditions: prior HF hospitalization, recent diuretic treatment, or recent brain natriuretic peptide increase [19]. Patients were implanted with an ICD with thoracic impedance measuring function, enabling the detection of achievement of an intrathoracic fluid threshold.…”