{"id":"751e06d7422b","type":"article","url":"https://hartvaat.nl/2024/10/03/uitgebreide-versus-standaard-remote-monitoring-bij-crt-en-hartfalen/","title":"Uitgebreide versus standaard remote monitoring bij CRT en hartfalen","title_en":"Comprehensive vs. standard remote monitoring of cardiac resynchronization devices in heart failure patients: results of the ECOST-CRT study.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euae233","source_url":"https://doi.org/10.1093/europace/euae233","authors":["Cédric Klein","Claude Kouakam","Arnaud Lazarus","Pascal de Groote","Christophe Bauters","Eloi Marijon","Frédéric Mouquet","Bruno Degand","Yves Guyomar","Jacques Mansourati","Christophe Leclercq","Laurence Guédon-Moreau"],"significance":5,"published":"2024-10-03","source_date":"2024-10-03","image":"","kennis":[],"congress":"","summary_en":"The ECOST-CRT study compared comprehensive remote monitoring — including patient questionnaires and heart failure-specific alerts — with standard remote monitoring in CRT patients. Comprehensive monitoring did not significantly improve clinical outcomes over standard device monitoring.","created":"2026-07-03T10:31:14Z","updated":"2026-07-03T13:30:15Z","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":"Studie vergeleek uitgebreide met standaard remote monitoring bij CRT-patiënten met hartfalen. Uitgebreide monitoring verbeterde de uitkomsten niet significant boven standaardmonitoring.","abstract_original":"AIMS: Integrating remote monitoring (RM) into existing healthcare practice for heart failure (HF) patients to improve clinical outcome remains challenging. The ECOST-CRT study compared the clinical outcome of a comprehensive RM scheme including a patient questionnaire capturing signs and symptoms of HF and notifications for HF specific parameters to traditional RM in patients with cardiac resynchronization therapy (CRT) devices. METHODS AND RESULTS: Patients were randomized 1:1 to standard daily RM (notification for technical parameters and ventricular arrhythmias; control group) or comprehensive RM (adding a monthly symptom questionnaire and notifications for biventricular pacing, premature ventricular contraction, atrial arrhythmias; active group). The primary endpoint was all-cause mortality or hospitalization for worsening HF (WHF). Six hundred fifty-two patients (70.4 ± 10.3 years, 73% men, left ventricular ejection fraction 29.1 ± 7.6%, 68% CRT-Defibrillators, 32% CRT-Pacemakers) were enrolled. The COVID-19 pandemic caused an early termination of the study, so the mean follow-up duration was 18 ± 8 months. No statistically significant difference in the primary endpoint was found between the groups [59 (18.3%) control vs. 77 (23.3%) active group; log-rank test P = 0.13]. Among the secondary endpoints, the MLHF questionnaire showed a larger share of patients with improvement of quality of life compared to baseline in the active group (78%) vs. control (61%; P = 0.03). CONCLUSION: The study does not support the notion that comprehensive RM, when compared to standard RM, in HF patients with CRT improves the clinical outcome of all-cause mortality or WHF hospitalizations. However, this study was underpowered due to an early termination and further trials are required. REGISTRATION: Clinical Trials.gov Identifier: NCT03012490."}