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Implant-based multi-parameter telemonitoring of patients with heart failure and a defibrillator with vs. without cardiac resynchronization therapy option: a subanalysis of the IN-TIME trial
JC. Geller, T. Lewalter, NE. Bruun, M. Taborsky, F. Bode, JC. Nielsen, C. Stellbrink, S. Schön, H. Mühling, H. Oswald, S. Reif, S. Kääb, P. Illes, J. Proff, N. Dagres, G. Hindricks, IN-TIME Study Group,
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články, multicentrická studie, randomizované kontrolované studie
NLK
ProQuest Central
od 2005-01-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 2000-08-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 2005-01-01 do Před 1 rokem
- MeSH
- defibrilátory implantabilní * MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití trendy MeSH
- následné studie MeSH
- příčina smrti trendy MeSH
- prospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- srdeční resynchronizační terapie metody MeSH
- systolické srdeční selhání mortalita patofyziologie terapie MeSH
- telemedicína metody MeSH
- tepový objem fyziologie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
- Geografické názvy
- Německo MeSH
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.
Center for Clinical Research Biotronik SE and Co KG Berlin Germany
Clinic for Cardiology and Angiology Hannover Medical School Hannover Germany
Department of Cardiology University Hospital Gentofte Hellerup Denmark
Department of Clinical Medicine Århus University Åarhus Denmark
Department of Electrophysiology University of Leipzig Heart Center Leipzig Germany
Department of Medicine 1 Cardiology Klinikum Großhadern Munich Germany
Medical Center for Cardiology Munich Germany
Citace poskytuje Crossref.org
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- $a Geller, Johann Christoph $u Arrhythmia and Invasive Electrophysiology Section, Division of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany. christoph.geller@zentralklinik.de. Otto-von-Guericke University School of Medicine, Magdeburg, Germany. christoph.geller@zentralklinik.de.
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- $a 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.
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