Remote monitoring and outcomes in heart failure: 5-year study.

Abstract

Aim: Managing heart failure is particularly challenging for patients with cardiac implantable electronic devices (CIEDs), often suffering from chronic conditions. This study aimed to evaluate the clinical outcomes of patients with implantable cardioverter-defibrillators or cardiac resynchronization therapy defibrillators who were remotely monitored over a 5-year period.

Methods: Clinical data were sourced from the Electrophysiology Registry of the Cardiology Unit. Survival rates, cardiovascular events (i.e. hospitalization or death), and the risk factors associated with these events were the main focus of the analysis. Univariate survival analyses were performed based on patient characteristics [ischemic disease, age over 75 years, atrial fibrillation, severe chronic kidney disease (CKD)]. Additionally, multivariate survival analysis was conducted using Cox regression.

Results: A total of N = 402 patients were included in the analysis. Over the 5-year follow-up, there were N = 68 deaths and N = 190 cardiovascular events. Kaplan-Meier analysis indicated that ischemic disease, age at least 75 years, atrial fibrillation and severe CKD were statistically significant risk factors for both death and cardiovascular events (log-rank test, P < 0.001). Cox regression analysis confirmed that ischemic disease, age 75 years and older, atrial fibrillation, implantation with a CRT-D device and severe CKD were all associated with a significantly higher risk of cardiovascular events and mortality.

Conclusion: Despite the proven effectiveness of remote monitoring, the clinical impact of heart failure in patients with CIEDs remains substantial. Continuous enhancements are necessary to facilitate early intervention and improve outcomes for these high-risk groups.