Remote monitoring for management of heart failure with reduced ejection fraction at home

The IN-TIME trial has shown benefits of remote monitoring using therapeutic cardiac implantable electronic devices in people with heart failure with reduced ejection fraction (HFrEF).

The trial was conducted across 36 tertiary clinical centres and hospitals in Europe (Austria, Czech Republic, Denmark, Germany and Latvia), Israel and Australia. The intervention included automatic and daily telemonitoring of the implanted device, with data transmitted to and reviewed by a team of research nurses and physicians working from a central monitoring unit. Data received could trigger a clinical response; for example, based on changing symptoms or rapid weight gain, the HF team could call the person with HF to assess their overall condition and adherence to medication, and depending on this could recommend a GP visit or an appointment at an HF clinic.

Study participants were followed-up for one year from enrolment. People who received telemonitoring support were less likely to experience worsening HF (including HF-related unplanned hospitalisation, worsening HF class or self-assessment, and death) than those who received standard care. Established guidelines suggest that this intervention may be considered in symptomatic people with HFrEF.

References

Ponikowski P, Voors AA, Anker SD, et al. 2016. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur J Heart Fail 18(8): 891-975

Hindricks G, Taborsky M, Glikson M, et al. 2014. Implant-based multiparameter telemonitoring of patients with heart failure (IN-TIME): a randomised controlled trial. Lancet 384(9943): 583-90

Brahmbhatt DH, Cowie MR. 2019. Remote Management of Heart Failure: An Overview of Telemonitoring Technologies. Card Fail Rev 5(2): 86-92