{"id":"ccd74d4eb41f","type":"article","url":"https://hartvaat.nl/2016/11/01/vochtstatustelemonitoring-bij-hartfalen-gerandomiseerde-trial/","title":"Vochtstatustelemonitoring bij hartfalen: gerandomiseerde trial","title_en":"Fluid status telemedicine alerts for heart failure: a randomized controlled trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["pathfinder-trial","step-hfpef"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehw099","source_url":"https://doi.org/10.1093/eurheartj/ehw099","authors":["Michael Böhm","Helmut Drexler","Hanno Oswald","Karin Rybak","Ralph Bosch","Christian Butter","Gunnar Klein","Bart Gerritse","Joao Monteiro","Carsten Israel","Dieter Bimmel","Stefan Käab","Burkhard Huegl","Johannes Brachmann"],"significance":6,"published":"2016-11-01","source_date":"2016-11-01","image":"","kennis":[],"congress":"","summary_en":"This randomized trial evaluated telemonitoring of fluid status for early detection of heart failure decompensation, testing whether automated alerts based on thoracic impedance changes prevent hospitalizations.","created":"2026-07-03T10:26:23Z","updated":"2026-07-03T18:38:28Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde trial naar telemonitoring van vochtbalans als signalering voor hartfalendecompensatie. Onderzoekt of remote vochtstatusdetectie hospitalisaties kan voorkomen.","abstract_original":"AIMS: Hospital admissions are frequently preceded by increased pulmonary congestion in heart failure (HF) patients. This study evaluated whether early automated fluid status alert notification via telemedicine improves outcome in HF patients. METHODS AND RESULTS: Patients recently implanted with an implantable cardioverter defibrillator (ICD) with or without cardiac resynchronization therapy were eligible if one of three conditions was met: prior HF hospitalization, recent diuretic treatment, or recent brain natriuretic peptide increase. Eligible patients were randomized (1:1) to have fluid status alerts automatically transmitted as inaudible text message alerts to the responsible physician or to receive standard care (no alerts). In the intervention arm, following a telemedicine alert, a protocol-specified algorithm with remote review of device data and telephone contact was prescribed to assess symptoms and initiate treatment. The primary endpoint was a composite of all-cause death and cardiovascular hospitalization. We followed 1002 patients for an average of 1.9 years. The primary endpoint occurred in 227 patients (45.0%) in the intervention arm and 239 patients (48.1%) in the control arm [hazard ratio, HR, 0.87; 95% confidence interval (CI), 0.72-1.04; P = 0.13]. There were 59 (11.7%) deaths in the intervention arm and 63 (12.7%) in the control arm (HR, 0.89; 95% CI, 0.62-1.28; P = 0.52). Twenty-four per cent of alerts were not transmitted and 30% were followed by a medical intervention. CONCLUSION: Among ICD patients with advanced HF, fluid status telemedicine alerts did not significantly improve outcomes. Adherence to treatment protocols by physicians and patients might be challenge for further developments in the telemedicine field."}