Telemonitoring gets to heart failure patients IN-TIME

The IN-TIME study showed an improvement in clinical outcomes in patients with heart failure who were telemonitored, according to results published online Aug. 16 in The Lancet.

The IN-TIME (INfluence of home moniToring on mortality and morbidity in heart failure patients with IMpaired lEft ventricular function) study assigned heart failure patients treated with implantable defibrillator to two groups: those regularly telemonitored (333 patients) and those given standard care without telemonitoring (control, 331 patients). Gerhard Hindricks, MD, PhD, of Herzzentrum Leipzig in Germany, and colleagues from other parts of Europe, Australia and Israel collaborated to review whether telemonitoring improved patient outcomes at one year.

Over the course of the study, Hindricks et al found that 18.9 percent of the telemonitoring patients and 27.2 percent of the controls experienced a worsening of their health status, including overnight hospital admission for heart failure, change in New York Heart Association class, change in patient global self-assessment, and all-cause death. Of the telemonitoring patients, 10 died as opposed to 27 control patients. The telemonitoring group experienced six cardiovascular-related deaths, whereas the control group had 21.

However, Hindricks et al found that the telemonitoring and control groups had similar admission rates for worsening heart failure and length of hospital stay. The number of patients affected was equally similar.

On the other hand, data provided by telemonitoring devices prompted more physician contact and follow-up with those patients exhibiting distress or trouble with their devices.

Hindricks et al noted three things that contributed to the improved clinical outcomes of the telemonitoring patients to varying degrees: early detection or progression of tachyarrythmias, recognition of suboptimal device function and prompting by the device to interview patients. Awareness of these situations allowed physicians to intercede early and provide changes in treatment or device and revealed issues that would not have been revealed until the next office visit.

While further analysis of the data will be occurring, Hindricks et al wrote that telemonitoring is feasible and should be used to monitor heart failure patients as part of standard clinical practice with implantable cardioverter-defibrillators and cardiac resynchronization-defibrillators.

This study was funded by Biotronik SE & Co. KG.