Efficacy of ICD/CRT-D Remote Monitoring in Patients With HFrEF: a Bayesian Meta-analysis of Randomized Controlled Trials

Curr Heart Fail Rep. 2022 Dec;19(6):435-444. doi: 10.1007/s11897-022-00579-6. Epub 2022 Oct 7.

Abstract

Purpose of review: To evaluate remote monitoring using implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) devices as an adjunctive tool to the traditional care of patients with heart failure (HF).

Recent findings: We included 11 trials encompassing 5965 patients. Absolute risk difference (ARD) with 95% credible interval (CrI) was estimated. Pooled (posterior) risk difference was computed using Bayesian hierarchical methods. The ARD for mortality was centered at - 0.01 (95% CrI: - 0.03; 0.01, Tau: 0.02), with an 82% probability of ARD of ICD/CRT-D remote monitoring with respect to control being less than 0. The ARD for cardiovascular mortality was centered at - 0.03 (95% CrI: - 0.11; 0.05, Tau: 0.10), with an 84% probability of ARD of ICD/CRT-D remote monitoring with respect to control being less than 0. ICD/CRT-D remote monitoring in patients with HF is associated with a higher probability of reduced all-cause and cardiovascular mortality compared with standard care alone.

Keywords: Cardiac resynchronization therapy; Heart failure; Implantable cardioverter-defibrillators; Mortality; Remote monitoring.

Publication types

  • Review

MeSH terms

  • Bayes Theorem
  • Cardiac Resynchronization Therapy* / adverse effects
  • Defibrillators, Implantable*
  • Heart Failure*
  • Humans
  • Randomized Controlled Trials as Topic
  • Stroke Volume
  • Treatment Outcome