Telemedical 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:...

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