Remote Monitoring of Cardiac Implantable Electronic Devices in Patients Undergoing Hybrid Comprehensive Telerehabilitation in Comparison to the Usual Care. Subanalysis from Telerehabilitation in Heart Failure Patients (TELEREH HF) Randomised Clinical Trial
Background: The impact of cardiac rehabilitation on the number of alerts in patients with remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) is unknown. We compared alerts in RM and outcomes in patients with CIEDs undergoing hybrid comprehensive telerehabilitation (HCTR) versus usual care (UC) Methods: Patients with heart failure (HF) after a hospitalization due to worsening HF within the last 6 months (New York Heart Association (NYHA) class I III and left ventricular ejection fraction (LVEF) =40% were enrolled in the TELEREH HF study and randomised 1:1 to HCTR or UC. Patients with HCTR and CIEDs received RM (HCTR RM) Patients with UC and CIEDs were offered RM optionally (UC RM) Data from the initial 9 weeks of the study were analysed. Results: Of 850 enrolled patients, 208 were in the HCTR RM group and 62 in the UC RM group. The HCTR RM group was less likely to have alerts of intrathoracic impedance (TI) decrease (p 0.001) atrial fibrillation (AF) occurrence (p 0.031) and lower mean number of alerts per patient associated with TI decrease (p 0.0001) and AF (p 0.019) than the UC RM group. HCTR significantly decreased the occurrence of alerts in RM of CIEDs, 0.360 (95%CI, 0.189 0.686; p 0.002) in multivariable regression analysis. There were two deaths in the HCTR RM group (0.96% and no deaths in the UC RM group (p 1.0) There were no differences in the number of hospitalised patients between the HCTR RM and UC RM group (p 1.0) Conclusions: HCTR significantly reduced the number of patients with RM alerts of CIEDs related to TI decrease and AF occurrence. There were no differences in mortality or hospitalisation rates between HCTR RM and UC RM groups.
Journal of clinical medicine