Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators: The Evolution of Management Strategies of Heart Failure Patients With Implantable Defibrillators (EVOLVO) Study

Landolina, Maurizio; Perego, Giovanni B.; Lunati, Maurizio; Curnis, Antonio; Guenzati, Giuseppe; Vicentini, Alessandro; Parati, Gianfranco; Borghi, Gabriella; Zanaboni, Paolo; Valsecchi, Sergio; Marzegalli, Maurizio

doi:10.1161/circulationaha.111.088971

Cited by 344Cardiac pacing and defibrillation studiesHeart Failure Treatment and ManagementTelemedicine and Telehealth Implementation

Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators: The Evolution of Management Strategies of Heart Failure Patients With Implantable Defibrillators (EVOLVO) Study

Landolina, Maurizio, Perego, Giovanni B., Lunati, Maurizio, Curnis, Antonio, Guenzati, Giuseppe, Vicentini, Alessandro, Parati, Gianfranco, Borghi, Gabriella +3 more·2012·Circulation

DOI 10.1161/circulationaha.111.088971

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Abstract

Background—: Heart failure patients with implantable cardioverter-defibrillators (ICDs) or an ICD for resynchronization therapy often visit the hospital for unscheduled examinations, placing a great burden on healthcare providers. We hypothesized that Internet-based remote interrogation systems could reduce emergency healthcare visits. Methods and Results—: This multicenter randomized trial involving 200 patients compared remote monitoring with standard patient management consisting of scheduled visits and patient response to audible ICD alerts. The primary end point was the rate of emergency department or urgent in-office visits for heart failure, arrhythmias, or ICD-related events. Over 16 months, such visits were 35% less frequent in the remote arm (75 versus 117; incidence density, 0.59 versus 0.93 events per year; P =0.005). A 21% difference was observed in the rates of total healthcare visits for heart failure, arrhythmias, or ICD-related events (4.40 versus 5.74 events per year; P <0.001). The time from an ICD alert condition to review of the data was reduced from 24.8 days in the standard arm to 1.4 days in the remote arm ( P <0.001). The patients' clinical status, as measured by the Clinical Composite Score, was similar in the 2 groups, whereas a more favorable change in quality of life (Minnesota Living With Heart Failure Questionnaire) was observed from the baseline to the 16th month in the remote arm ( P =0.026). Conclusions—: Remote monitoring reduces emergency department/urgent in-office visits and, in general, total healthcare use in patients with ICD or defibrillators for resynchronization therapy. Compared with standard follow-up through in-office visits and audible ICD alerts, remote monitoring results in increased efficiency for healthcare providers and improved quality of care for patients. Clinical Trial Registration—: URL: http://www.clinicaltrials.gov . Unique identifier: NCT00873899.

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We know less about the impact of remote monitoring on patients' quality of life.
“although we know less about its impact on patients’ QoL. [22, 23]”
From Effectiveness of a comprehensive interactive eHealth intervention on patient-reported and clinical outcomes in patients with an implantable cardioverter defibrillator ACQUIRE-ICD trial.: study protocol of a national Danish randomised controlled trial (2018) · cites this paper as [22]

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Authors: Landolina, M., Perego, G. B., Lunati, M., Curnis, A., Guenzati, G., Vicentini, A., Parati, G., Borghi, G., Zanaboni, P., Valsecchi, S., & Marzegalli, M.
Affiliations: University Hospital of North Norway (NO)
ORCID: Landolina, Maurizio
Perego, Giovanni B.
Lunati, Maurizio
Vicentini, Alessandro
Parati, Gianfranco
Zanaboni, Paolo
Valsecchi, Sergio
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2012-06-19
Volume: 125
Issue: 24
Pages: 2985-2992
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.111.088971
OpenAlex: W2148896305
Cited by: 344
References: 36
Citations by year: 2026: 10 · 2025: 18 · 2024: 14 · 2023: 24 · 2022: 20 · 2021: 27 · 2020: 22 · 2019: 22 · 2018: 21 · 2017: 33 · 2016: 28 · 2015: 36 · 2014: 32 · 2013: 33 · 2012: 4
FWCI: 21.61
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
BOA (University of Milano-Bicocca) (submittedVersion)
Funders: Medtronic
Ministero della Salute
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords: remote monitoring, implantable cardioverter-defibrillator, heart failure, cardiac resynchronization therapy, health care utilization, emergency department visits, quality of life, quality of care
MeSH terms: Aged, Female, Heart Failure, Humans, Male, Middle Aged, Monitoring, Physiologic, Prospective Studies, Quality of Health Care, Quality of Life, Defibrillators, Implantable, Remote Consultation, Internet

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Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators: The Evolution of Management Strategies of Heart Failure Patients With Implantable Defibrillators (EVOLVO) Study

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