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Influence of Remote Monitoring on Long-Term Cardiovascular Outcomes after Cardioverter-Defibrillator Implantation

2016-07-27Journal article Open access
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dc.contributor.authorPortugal, G
dc.contributor.authorCunha, PS
dc.contributor.authorValente, B
dc.contributor.authorFeliciano, J
dc.contributor.authorLousinha, A
dc.contributor.authorAlves, S
dc.contributor.authorBraz, M
dc.contributor.authorPimenta, R
dc.contributor.authorDelgado, AS
dc.contributor.authorOliveira, MM
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2016-08-22T14:58:03Z
dc.date.available2016-08-22T14:58:03Z
dc.date.issued2016-07-27
dc.description.abstractAIMS: Device-based remote monitoring (RM) has been linked to improved clinical outcomes at short to medium-term follow-up. Whether this benefit extends to long-term follow-up is unknown. We sought to assess the effect of device-based RM on long-term clinical outcomes in recipients of implantable cardioverter-defibrillators (ICD). METHODS: We performed a retrospective cohort study of consecutive patients who underwent ICD implantation for primary prevention. RM was initiated with patient consent according to availability of RM hardware at implantation. Patients with concomitant cardiac resynchronization therapy were excluded. Data on hospitalizations, mortality and cause of death were systematically assessed using a nationwide healthcare platform. A Cox proportional hazards model was employed to estimate the effect of RM on mortality and a composite endpoint of cardiovascular mortality and hospital admission due to heart failure (HF). RESULTS: 312 patients were included with a median follow-up of 37.7months (range 1 to 146). 121 patients (38.2%) were under RM since the first outpatient visit post-ICD and 191 were in conventional follow-up. No differences were found regarding age, left ventricular ejection fraction, heart failure etiology or NYHA class at implantation. Patients under RM had higher long-term survival (hazard ratio [HR] 0.50, CI 0.27-0.93, p=0.029) and lower incidence of the composite outcome (HR 0.47, CI 0.27-0.82, p=0.008). After multivariate survival analysis, overall survival was independently associated with younger age, higher LVEF, NYHA class lower than 3 and RM. CONCLUSION: RM was independently associated with increased long-term survival and a lower incidence of a composite endpoint of hospitalization for HF or cardiovascular mortality.pt_PT
dc.identifier.citationInt J Cardiol. 2016 Jul 27;222:764-768pt_PT
dc.identifier.doi10.1016/j.ijcard.2016.07.157pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2560
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHSM CARpt_PT
dc.subjectDeath, Sudden, Cardiac/epidemiologypt_PT
dc.subjectDeath, Sudden, Cardiac/prevention & controlpt_PT
dc.subjectDefibrillators, Implantable
dc.subjectFollow-Up Studies
dc.subjectHeart Failure/mortality
dc.subjectHeart Failure/physiopathology
dc.subjectHeart Failure/therapy
dc.subjectIncidence
dc.subjectMonitoring, Physiologic/methods
dc.subjectPortugal/epidemiology
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectStroke Volume/physiology
dc.subjectSurvival Rate/trends
dc.subjectTelemedicine/methods
dc.subjectTime Factors
dc.subjectTreatment Outcome
dc.subjectVentricular Function, Left/physiology
dc.titleInfluence of Remote Monitoring on Long-Term Cardiovascular Outcomes after Cardioverter-Defibrillator Implantationpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage768pt_PT
oaire.citation.startPage764pt_PT
oaire.citation.titleInternational Journal of Cardiologypt_PT
oaire.citation.volume222pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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