Browsing by Author "Schieber, Michael"
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- ItemImpact of remote telemedical management on mortality and hospitalizations in ambulatory patients with chronic heart failure: the telemedical interventional monitoring in heart failure study.(2011-05-03) Koehler, Friedrich; Winkler, Sebastian; Schieber, Michael; Sechtem, Udo; Stangl, Karl; Böhm, Michael; Boll, Herbert; Baumann, Gert; Honold, Marcus; Koehler, Kerstin; Gelbrich, Goetz; Kirwan, Bridget-Anne; Anker, Stefan D; ,BACKGROUND This study was designed to determine whether physician led remote telemedical management RTM compared with usual care would result in reduced mortality in ambulatory patients with chronic heart failure HF METHODS AND RESULTS We enrolled 710 stable chronic HF patients in New York Heart Association functional class II or III with a left ventricular ejection fraction 35 and a history of HF decompensation within the previous 2 years or with a left ventricular ejection fraction 25 Patients were randomly assigned 1 1 to RTM or usual care Remote telemedical management used portable devices for ECG blood pressure and body weight measurements connected to a personal digital assistant that sent automated encrypted transmission via cell phones to the telemedical centers The primary end point was death from any cause The first secondary end point was a composite of cardiovascular death and hospitalization for HF Baseline characteristics were similar between the RTM n 354 and control n 356 groups Of the patients assigned to RTM 287 81 were at least 70 compliant with daily data transfers and no break for 30 days except during hospitalizations The median follow up was 26 months minimum 12 and was 99 9 complete Compared with usual care RTM had no significant effect on all cause mortality hazard ratio 0 97 95 confidence interval 0 67 to 1 41 P 0 87 or on cardiovascular death or HF hospitalization hazard ratio 0 89 95 confidence interval 0 67 to 1 19 P 0 44 CONCLUSIONS In ambulatory patients with chronic HF RTM compared with usual care was not associated with a reduction in all cause mortality CLINICAL TRIAL REGISTRATION URL http www ClinicalTrials gov Unique identifier NCT00543881
- ItemA new telemonitoring system intended for chronic heart failure patients using mobile telephone technology--feasibility study.(2011-11-14) Winkler, Sebastian; Schieber, Michael; Lücke, Stephanie; Heinze, Peter; Schweizer, Thomas; Wegertseder, Dominik; Scherf, Michael; Nettlau, Herbert; Henke, Sascha; Braecklein, Martin; Anker, Stefan D; Koehler, FriedrichBACKGROUND Remote monitoring is one modality of structured care in chronic heart failure The purpose of this study was to evaluate the feasibility of a new wireless telemonitoring system via a mobile phone network METHODS Portable home devices for electrocardiogram blood pressure body weight and self assessment measurements were connected via Bluetooth to a personal digital assistant PDA that performs automated encrypted transmission via mobile phone Two telemedical centres were set up RESULTS 30 healthy volunteers were enrolled and followed for 26 days A total of 4002 single measurements were taken 133 37 per person No data was lost or incorrectly allocated 880 of 937 94 of the ECG recordings had sufficient diagnostic quality for rhythm analysis and single beat measurements 50 continuous ECG streams 312 min without disruption were performed Total system availability was 96 6 including that of the mobile phone network CONCLUSIONS Mobile phone technology is suitable for continuous and secure medical data transmission To evaluate the clinical use in chronic heart failure patients a large multicentre randomized controlled trial ClinicalTrials gov Identifier NCT00543881 was started
- ItemTelemedical Interventional Monitoring in Heart Failure (TIM-HF), a randomized, controlled intervention trial investigating the impact of telemedicine on mortality in ambulatory patients with heart failure:...(2010-11-24) Koehler, Friedrich; Winkler, Sebastian; Schieber, Michael; Sechtem, Udo; Stangl, Karl; Böhm, Michael; Boll, Herbert; Kim, Simone S; Koehler, Kerstin; Lücke, Stephanie; Honold, Marcus; Heinze, Peter; Schweizer, Thomas; Braecklein, Martin; Kirwan, Bridget-Anne; Gelbrich, Goetz; Anker, Stefan D; ,Remote patient management telemonitoring may help to detect early signs of cardiac decompensation allowing optimization of and adherence to treatments in chronic heart failure CHF Two meta analyses have suggested that telemedicine in CHF can reduce mortality by 30 35 The aim of the TIM HF study was to investigate the impact of telemedical management on mortality in ambulatory CHF patients Methods CHF patients New York Heart Association NYHA II III left ventricular ejection fraction LVEF 35 with a history of cardiac decompensation with hospitalization in the past or therapy with intravenous diuretics in the prior 24 months no decompensation required if LVEF 25 were randomized 1 1 to an intervention group of daily remote device monitoring electrocardiogram blood pressure body weight coupled with medical telephone support or to usual care led by the patients local physician In the intervention group 24 7 physician led medical support was provided by two central telemedical centres A clinical event committee blinded to treatment allocation assessed cause of death and reason for hospitalization The primary endpoint was total mortality The first secondary endpoint was a composite of cardiovascular mortality or hospitalization due to heart failure Other secondary endpoints included cardiovascular mortality all cause and cause specific hospitalizations all time to first event as well as days lost due to heart failure hospitalization or cardiovascular death in of follow up time and changes in quality of life and NYHA class Overall 710 CHF patients were recruited The mean follow up was 21 5 7 2 months with a minimum of 12 months Perspective The study will provide important prospective outcome data on the impact of telemedical management in patients with CHF