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Impact of Remote Telemedical Management on Mortality and Hospitalizations in Ambulatory Patients With Chronic Heart Failure: The Telemedical Interventional Monitoring in Heart Failure Study
Open accessAbstract
Background—: This study was designed to determine whether physician-led remote telemedical management (RTM) compared with usual care would result in reduced mortality in ambulatory patients with chronic heart failure (HF). Methods and Results—: We enrolled 710 stable chronic HF patients in New York Heart Association functional class II or III with a left ventricular ejection fraction ≤35% and a history of HF decompensation within the previous 2 years or with a left ventricular ejection fraction ≤25%. Patients were randomly assigned (1:1) to RTM or usual care. Remote telemedical management used portable devices for ECG, blood pressure, and body weight measurements connected to a personal digital assistant that sent automated encrypted transmission via cell phones to the telemedical centers. The primary end point was death from any cause. The first secondary end point was a composite of cardiovascular death and hospitalization for HF. Baseline characteristics were similar between the RTM (n=354) and control (n=356) groups. Of the patients assigned to RTM, 287 (81%) were at least 70% compliant with daily data transfers and no break for >30 days (except during hospitalizations). The median follow-up was 26 months (minimum 12), and was 99.9% complete. Compared with usual care, RTM had no significant effect on all-cause mortality (hazard ratio, 0.97; 95% confidence interval, 0.67 to 1.41; P =0.87) or on cardiovascular death or HF hospitalization (hazard ratio, 0.89; 95% confidence interval, 0.67 to 1.19; P =0.44). Conclusions—: In ambulatory patients with chronic HF, RTM compared with usual care was not associated with a reduction in all-cause mortality. Clinical Trial Registration:—: URL: http://www.ClinicalTrials.gov . Unique identifier: NCT00543881.
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“TEN-HMS, TIM-HF and BEAT-HF trials showed that a remote telemonitoring intervention did not reduce HF hospitalizations and all-cause mortality68–70”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [69]
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“The TIM-HF trial69 randomly assigned 710 patients with an LVEF of ≤35%, NYHA class II–III and a history of HF decompensation within the previous 2 years to telemonitoring (weight, BP and heart rhythm data transmission) compared with usual care and found no differences between the groups in cardiovascular and all-cause mortality or in hospitalizations at a median follow-up of 26 months.”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [69]
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McDonagh, T. A., Metra, M., Adamo, M., Gardner, R. S., Baumbach, A., Böhm, M., Burri, H., Butler, J., Čelutkienė, J., Chioncel, O. D., et al. (2021) · PubMed · doi:10.1093/eurheartj/ehab670 · Cited by 20,604
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2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure
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Metadata
- Authors
- Koehler, F., Winkler, S., Schieber, M., Sechtem, U., Stangl, K., Böhm, M., Boll, H., Baumann, G., Honold, M., Koehler, K., Gelbrich, G., Kirwan, B.-A., & Anker, S. D.
- Affiliations
- Robert Bosch Hospital (DE)
- ORCID
- Venue
- Circulation
- Published
- 2011-05-03
- Volume
- 123
- Issue
- 17
- Pages
- 1873-1880
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2152527332
- Cited by
- 716
- References
- 14
- Citations by year
- 2026: 25 · 2025: 29 · 2024: 34 · 2023: 37 · 2022: 57 · 2021: 62 · 2020: 43 · 2019: 35 · 2018: 51 · 2017: 68 · 2016: 48 · 2015: 57 · 2014: 45 · 2013: 43 · 2012: 57
- FWCI
- 53.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- University of Bedfordshire Repository (University of Bedfordshire) (submittedVersion)
- Funders
- Bundesministerium für Wirtschaft und Technologie
- Deutsches Zentrum für Luft- und Raumfahrt
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- chronic heart failure, outpatients, all-cause mortality, cardiovascular mortality, heart failure hospitalization, remote monitoring, telemedicine, left ventricular ejection fraction
- MeSH terms
- Aged, Ambulatory Care, Blood Pressure, Body Weight, Electrocardiography, Female, Follow-Up Studies, Heart Failure, Hospitalization, Humans, Male, Managed Care Programs, Middle Aged, Quality of Life, Outcome Assessment, Health Care, Telemedicine, Computers, Handheld
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