Journal Articles EP-Europace Year : 2025

Comprehensive vs. standard remote monitoring of cardiac resynchronization devices in heart failure patients: results of the ECOST-CRT study

Arnaud Lazarus
Frédéric Mouquet
Yves Guyomar
Laurence Guédon-Moreau
Maxime Pons
  • Function : Author
Daniel Gras
  • Function : Author
Caroline Himbert
  • Function : Author
Christophe Leclercq
  • Function : Author
Jean-Luc Pasquie
  • Function : Author
Romain Eschalier
  • Function : Author
Halim Marzak
  • Function : Author
Michel Boursier
  • Function : Author
François Jourda
  • Function : Author
Frédéric Anselme
  • Function : Author
Hervé Gorka
  • Function : Author
Olivier Billon
  • Function : Author
Laure Champ-Rigot
  • Function : Author
Mina Ait Said
  • Function : Author
Jérôme Taieb
  • Function : Author
Marc Badoz
  • Function : Author
Julien Laborderie
  • Function : Author
Mohamed Belhameche
  • Function : Author
Sylvain Ploux
  • Function : Author
Maxime de Guillebon
  • Function : Author
Antoine Dompnier
  • Function : Author
Serge Boveda
  • Function : Author
Sophie Gomes-Ferreira
  • Function : Author
Cédric Giraudeau
  • Function : Author
Michael Peyrol
  • Function : Author
Pierre Winum
  • Function : Author
Benjamin Gal
  • Function : Author
Hugues Blangy
  • Function : Author
Olivier Le Vavasseur
  • Function : Author
Alexandre Duparc
  • Function : Author
Laura Forelle
  • Function : Author
Albin Behaghel
  • Function : Author
Renaud Fouche
  • Function : Author
Gabriel Laurent
  • Function : Author
Hassan Barake
  • Function : Author
Sylvain Reuter
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Pierre Sultan
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Antoine da Costa
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Abstract

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
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hal-04905237 , version 1 (22-01-2025)

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Cédric Klein, Claude Kouakam, Arnaud Lazarus, Pascal de Groote, Christophe Bauters, et al.. Comprehensive vs. standard remote monitoring of cardiac resynchronization devices in heart failure patients: results of the ECOST-CRT study. EP-Europace, 2025, 26 (10), pp.euae233. ⟨10.1093/europace/euae233⟩. ⟨hal-04905237⟩
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