Vol 35: Superiority of automatic remote monitoring compared with in-person evaluation for scheduled ICD follow-up in the TRUST trial - testing execution of the recommendations.Report as inadecuate



 Vol 35: Superiority of automatic remote monitoring compared with in-person evaluation for scheduled ICD follow-up in the TRUST trial - testing execution of the recommendations.


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This article is from European Heart Journal, volume 35.AbstractAims: To test recommended implantable cardioverter defibrillator ICD follow-up methods by ‘in-person evaluations’ IPE vs. ‘remote Home Monitoring’ HM. Methods and results: ICD patients were randomized 2:1 to automatic HM or to Conventional monitoring, with follow-up checks scheduled at 3, 6, 9, 12, and 15 months post-implant. Conventional patients were evaluated with IPE only. Home Monitoring patients were assessed remotely only for 1 year between 3 and 15 month evaluations. Adherence to follow-up was measured. HM and Conventional patients were similar age 63 years, 72% male, left ventricular ejection fraction 29%, primary prevention 73%, DDD 57%. Conventional management suffered greater patient attrition during the trial 20.1 vs. 14.2% in HM, P = 0.007. Three month follow-up occurred in 84% in both groups. There was 100% adherence 5 of 5 checks in 47.3% Conventional vs. 59.7% HM P 0.001. Between 3 and 15 months, HM exhibited superior 2.2× adherence to scheduled follow-up incidence of failed follow up was 146 of 2421 6.0% in HM vs. 145 of 1098 13.2% in Conventional, P 0.001 and punctuality. In HM daily transmission success rate median 91%, transmission loss caused only 22 of 2275 0.97% failed HM evaluations between 3 and 15 months; others resulted from clinic oversight. Overall IPE failure rate in Conventional 193 of 1841 10.5% exceeded that in HM 97 of 1484 6.5%, P 0.001 by 62%, i.e. HM patients remained more loyal to IPE when this was mandated. Conclusion: Automatic remote monitoring better preserves patient retention and adherence to scheduled follow-up compared with IPE. Clinical trial registration: NCT00336284.



Author: Varma, Niraj; Michalski, Justin; Stambler, Bruce; Pavri, Behzad B.

Source: https://archive.org/



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