Impact of Remote Monitoring on Long‐Term Prognosis in Heart Failure Patients in a Real‐World Cohort: Results From All‐Comers COMMIT‐HF Trial

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Over the last years, the introduction of remote monitoring (RM) of implantable cardioverter–defibrillators (ICDs) and cardiac resynchronization therapy device–defibrillators (CRT‐Ds) has significantly improved quality of care and prognosis in heart failure (HF) patients. ICDs/CRT‐Ds collect detailed information of device function and various physiological parameters to monitor the clinical status of the patient, including the patient's activity, transthoracic impedance, heart rate variability, and arrhythmia burden. Previous trials showed that RM reduces the time from onset of adverse events to clinical decision and decreases the number of in‐clinic visits, while not simultaneously impairing safety.1 Moreover, several studies showed a reduction in the number of ICD shocks in an RM group.1 Based on these results, RM was endorsed by a joint European and American Expert Consensus Statement7 and the 2013 European Society of Cardiology guidelines on cardiac pacing and cardiac resynchronization therapy8 as a class I or IIa recommendation.
The In‐TIME study revealed that multiparameter telemonitoring significantly improves clinical outcomes in patients with HF, with a reduction of 1‐year mortality.6 Similar data come from the EFFECT study, which showed a significant reduction in 1‐year mortality in an RM group (5% vs. 7%, in the favor of RM group).9 However, as stated by the authors, information system differences as well as the fact that devices were provided by a single manufacturer were obvious limitations to both studies. Moreover, those findings were based on control trials and do not fully reflect a real‐world experience.
There is still a paucity of data regarding the impact of RM on long‐term prognosis in patients derived from all‐comers registries equipped with systems produced by different manufacturers. Therefore, this study aimed to analyze the impact of RM on mortality and hospitalization rate using an all‐comers prospective observational registry from a high‐volume cardiovascular center.

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