Remote monitoring improves survival in patients with cardiac resynchronization therapy: Retrospective observational study

Peter Bogyi, Mate Vamos, Zsolt Bari, Balazs Polgar, Balazs Muk, Noemi Nyolczas, R. Kiss, G. Duray

Research output: Article

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 cardiac resynchronization defibrillator therapy (CRT-D) implantation in a large-volume tertiary referral center. Methods: The population of this single-center, 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 conventional follow-up. Results: The mean follow-up time was 28.4 (SD 18.1) months. Patients on remote monitoring were more likely to have atrial fibrillation, received heart failure management at our dedicated heart failure outpatient clinic more often, and have a slightly lower functional capacity. Crude all-cause mortality of remote-monitored patients was significantly lower compared with patients followed conventionally (hazard ratio [HR] 0.368, 95% CI 0.186-0.727, P=.004). The survival benefit remained statistically significant after adjustment for important baseline parameters (adjusted HR 0.361, 95% CI 0.181-0.722, P=.004). Conclusions: In this single-center, retrospective study of optimally treated heart failure patients undergoing CRT-D implantation, the use of remote monitoring systems was associated with a significantly better survival rate.

Original languageEnglish
Article numbere14142
JournalJournal of medical Internet research
Volume21
Issue number7
DOIs
Publication statusPublished - jan. 1 2019

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Cardiac Resynchronization Therapy
Observational Studies
Retrospective Studies
Survival
Defibrillators
Heart Failure
Cardiac Resynchronization Therapy Devices
Mortality
Hungary
Ambulatory Care Facilities
Tertiary Care Centers
Atrial Fibrillation
Population
Survival Rate
Guidelines
Technology

ASJC Scopus subject areas

  • Health Informatics

Cite this

Remote monitoring improves survival in patients with cardiac resynchronization therapy : Retrospective observational study. / Bogyi, Peter; Vamos, Mate; Bari, Zsolt; Polgar, Balazs; Muk, Balazs; Nyolczas, Noemi; Kiss, R.; Duray, G.

In: Journal of medical Internet research, Vol. 21, No. 7, e14142, 01.01.2019.

Research output: Article

Bogyi, Peter ; Vamos, Mate ; Bari, Zsolt ; Polgar, Balazs ; Muk, Balazs ; Nyolczas, Noemi ; Kiss, R. ; Duray, G. / Remote monitoring improves survival in patients with cardiac resynchronization therapy : Retrospective observational study. In: Journal of medical Internet research. 2019 ; Vol. 21, No. 7.
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