Preliminary effects of renal denervation with saline irrigated catheter on cardiac systolic function in patients with heart failure: A prospective, randomized, controlled, pilot study

2016 ◽  
Vol 89 (4) ◽  
pp. E153-E161 ◽  
Author(s):  
Weijie Chen ◽  
Zhiyu Ling ◽  
Yanping Xu ◽  
Zengzhang Liu ◽  
Li Su ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pilot Study ◽  
Renal Denervation ◽  
Systolic Function ◽  
Randomized Controlled ◽  
Patients With Heart Failure ◽  
Cardiac Systolic Function ◽  
Irrigated Catheter

scholarly journals Impact of Remote Titration Combined With Telemonitoring on the Optimization of Guideline-Directed Medical Therapy for Patients With Heart Failure: Internal Pilot of a Randomized Controlled Trial

JMIR Cardio ◽  
10.2196/21962 ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. e21962
Author(s):  
Veronica Artanian ◽  
Heather J Ross ◽  
Valeria E Rac ◽  
Mary O'Sullivan ◽  
Darshan H Brahmbhatt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pilot Study ◽  
Medical Therapy ◽  
Intervention Group ◽  
Dose Optimization ◽  
Control Group ◽  
Internal Pilot ◽  
Randomized Controlled ◽  
Patients With Heart Failure ◽  
Clinic Visits

Background To improve health outcomes in patients with heart failure, guideline-directed medical therapy (GDMT) should be optimized to target doses. However, GDMT remains underutilized, with less than 25% of patients receiving target doses in clinical practice. Telemonitoring could provide reliable and real-time physiological data for clinical decision support to facilitate remote GDMT titration. Objective This paper aims to present findings from an internal pilot study regarding the effectiveness of remote titration facilitated by telemonitoring. Methods A 2-arm randomized controlled pilot trial comparing remote titration versus standard care in a heart function clinic was conducted. Patients were randomized to undergo remote medication titration facilitated by data from a smartphone-based telemonitoring system or standard titration performed during clinic visits. Results A total of 42 patients with new-onset (10/42, 24%) and existing (32/42, 76%) heart failure and a mean age of 55.29 (SD 11.28) years were randomized between January and June 2019. Within 6 months of enrollment, 86% (18/21) of patients in the intervention group achieved optimal doses versus 48% (10/21) of patients in the control group. The median time to dose optimization was 11.0 weeks for the intervention group versus 18.8 weeks for the control group. The number of in-person visits in the intervention group was 54.5% lower than in the control group. Conclusions The results of this pilot study suggest that remote titration facilitated by telemonitoring has the potential to increase the proportion of patients who achieve optimal GDMT doses, decrease time to dose optimization, and reduce the number of clinic visits. Remote titration may facilitate optimal and efficient titration of patients with heart failure while reducing the burden for patients to attend in-person clinic visits. Trial Registration ClinicalTrials.gov NCT04205513; https://clinicaltrials.gov/ct2/show/NCT04205513 International Registered Report Identifier (IRRID) RR2-10.2196/preprints.19705

scholarly journals Impact of Remote Titration Combined With Telemonitoring on the Optimization of Guideline-Directed Medical Therapy for Patients With Heart Failure: Internal Pilot of a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Veronica Artanian ◽  
Heather J Ross ◽  
Valeria E Rac ◽  
Mary O'Sullivan ◽  
Darshan H Brahmbhatt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pilot Study ◽  
Medical Therapy ◽  
Intervention Group ◽  
Dose Optimization ◽  
Control Group ◽  
Internal Pilot ◽  
Randomized Controlled ◽  
Patients With Heart Failure ◽  
Clinic Visits

BACKGROUND To improve health outcomes in patients with heart failure, guideline-directed medical therapy (GDMT) should be optimized to target doses. However, GDMT remains underutilized, with less than 25% of patients receiving target doses in clinical practice. Telemonitoring could provide reliable and real-time physiological data for clinical decision support to facilitate remote GDMT titration. OBJECTIVE This paper aims to present findings from an internal pilot study regarding the effectiveness of remote titration facilitated by telemonitoring. METHODS A 2-arm randomized controlled pilot trial comparing remote titration versus standard care in a heart function clinic was conducted. Patients were randomized to undergo remote medication titration facilitated by data from a smartphone-based telemonitoring system or standard titration performed during clinic visits. RESULTS A total of 42 patients with new-onset (10/42, 24%) and existing (32/42, 76%) heart failure and a mean age of 55.29 (SD 11.28) years were randomized between January and June 2019. Within 6 months of enrollment, 86% (18/21) of patients in the intervention group achieved optimal doses versus 48% (10/21) of patients in the control group. The median time to dose optimization was 11.0 weeks for the intervention group versus 18.8 weeks for the control group. The number of in-person visits in the intervention group was 54.5% lower than in the control group. CONCLUSIONS The results of this pilot study suggest that remote titration facilitated by telemonitoring has the potential to increase the proportion of patients who achieve optimal GDMT doses, decrease time to dose optimization, and reduce the number of clinic visits. Remote titration may facilitate optimal and efficient titration of patients with heart failure while reducing the burden for patients to attend in-person clinic visits. CLINICALTRIAL ClinicalTrials.gov NCT04205513; https://clinicaltrials.gov/ct2/show/NCT04205513 INTERNATIONAL REGISTERED REPORT RR2-10.2196/preprints.19705

Sign in / Sign up

Export Citation Format

Share Document