REM-HF: REmote Monitoring an evaluation of implantable devices for management of Heart Failure Patients

Abstract

There is a pressing need to develop new ways of managing the rapidly increasing number of people living with heart failure in the UK. The epidemic of heart failure has arisen because of the rapidly ageing population and dramatic improvements in the survival from acute coronary disease and heart failure. Remote monitoring of heart failure using automated implanted devices and bespoke care pathways/protocols to give early warning of deterioration and facilitate pre-emptive action may be an important solution to the dual problem of increasing healthcare need but static (or reducing) healthcare resource. This study randomises a typical population of patients with heart failure who have implanted devices capable of being monitored remotely to either protocol-driven care informed by weekly remote monitoring, or to usual care. The study is powered to detect a clinically-meaningful reduction in all cause mortality and cardiovascular hospitalisation as the primary endpoint, with secondary endpoints that include cost effectiveness. The results of this study could potentially change NHS practice for many tens of thousands of patients with heart failure, facilitating an integration of modern technology with evidence-based treatment to optimise health gain and value for money in the health service.

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