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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ERemote monitoring using a multiparametric alert algorithm in patients with heart failure (HF) and a cardiac resynchronization therapy device (CRT-D) or implanted cardiac defibrillator (ICD) results in a decrease in all-cause mortality. This article presents data from a post hoc analysis of the Influence of Home Monitoring on the Clinical Status of Heart Failure Patients With an Impaired Left Ventricular Function trial [IN-TIME; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00538356\u0026amp;atom=%2Fspmdc%2F14%2F12%2F24.atom\u0022\u003ENCT00538356\u003C\/a\u003E].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHeart Failure\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology \u0026amp; Cardiovascular Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHeart Failure\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ERemote monitoring using a multiparametric alert algorithm in patients with heart failure (HF) and a cardiac resynchronization therapy device (CRT-D) or implanted cardiac defibrillator (ICD) results in a decrease in all-cause mortality. Gerhard Hindricks, MD, PhD, Herzzentrum Leipzig, Leipzig, Germany, presented data from a post hoc analysis of the Influence of Home Monitoring on the Clinical Status of Heart Failure Patients With an Impaired Left Ventricular Function trial [IN-TIME; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00538356\u0026amp;atom=%2Fspmdc%2F14%2F12%2F24.atom\u0022\u003ENCT00538356\u003C\/a\u003E].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EPatients with HF have a high risk of experiencing substantial morbidity, with a generally poor prognosis. Interestingly, certain clinical parameter trends frequently occur prior to patient re-hospitalization or death due to worsening HF [Hindricks G et al. \u003Cem\u003EESC\u003C\/em\u003E 2013]. The purpose of the IN-TIME trial was to evaluate the utility of remote monitoring on clinical outcomes using a multiparametric alert approach in patients with HF and a CRT-D or an ICD.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn the multicenter, open-label, Phase 4 IN-TIME trial, 664 patients with HF, who required a CRT-D or dual-chamber ICD, were randomly assigned to home monitoring (n=333) or to conventional monitoring (n=331) groups. Patients were classified as New York Heart Association (NYHA) Class II or III with a left ventricular ejection fraction (LVEF) of less than or equal to 35%, and were on stable drug therapy. Patients were excluded if they had permanent atrial fibrillation. The mean age of patients with a CRT-D was 67 years; of these, 78% were male, 26% were NYHA Class II, 61% had coronary artery disease (CAD), and 34% had renal insufficiency. The mean intrinsic QRS duration for these patients was 148 ms. By comparison, the mean age of patients with an ICD was 63 years; of these, 85% were male, 67% were NYHA Class II, 80% had CAD, and 24% had renal insufficiency. The mean LVEF in these patients was 27%, and the mean intrinsic QRS duration was 114 ms.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe primary end point was the modified Packer score\u2014a clinical composite that comprises mortality, NYHA class global self-assessment, and the need for overnight hospitalization for worsening heart failure. The major secondary end point was all-cause mortality. The patient\u0027s condition was considered to be \u201cworsened\u201d if the following criteria occurred: death, overnight hospitalization for worsening HF, worsening in NYHA class, and deterioration in global self-assessment score.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThere was no significant difference in the modified Packer score between patients in the conventional and home monitoring groups, regardless of the device type (30% vs 23%, p=0.10 for CRT-D; 23% vs 14%, p=0.06 for ICD). However, mortality rates was significantly lower for patients with CRT-D in the home monitoring group as compared with those in the conventional monitoring group (HR, 0.35; p=0.014; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E); similar lower mortality rates were observed for patients with an ICD in the home monitoring group as compared with those in the conventional monitoring group.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/12\/24\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Effect of Remote Home Monitoring on Mortality in Patients With CRT-D\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1709063222\u0022 data-figure-caption=\u0022Effect of Remote Home Monitoring on Mortality in Patients With CRT-D\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/12\/24\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/12\/24\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/12\/24\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14358\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EEffect of Remote Home Monitoring on Mortality in Patients With CRT-D\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003ECRT-D=cardiac resynchronization therapy device; HM=home monitoring.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from G Hindricks, MD, PhD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003EIn patients with a CRT-D or an ICD in the home monitoring group, 1.7 and 1.1 clinical events per patient-year were detected, respectively. The commonly detected clinical events included atrial fibrillation, CRT (in CRT-D group) and lead parameters. In addition, technical and medical issues were identified in 291 and 146 of patients with a CRT-D and an ICD in the home monitoring group, respectively.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EProf. Hindricks concluded that there is a clinical benefit in using remote home monitoring for implantbased devices, regardless of the type of device employed (CRT-D or ICD).\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/12\/24.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzp5xp\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzp5xp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}