The European Heart Journal has published the clinical results of the ECOST trial (Effectiveness and cost of ICD follow-up schedule with telecardiology). The randomised controlled study evaluated the safety and efficacy of Biotronik’s Home Monitoring compared with standard in-office follow-up visits for patients with implantable cardioverter-defibrillators (ICDs).
Results from ECOST provided evidence that continuous remote monitoring with Home Monitoring reduces inappropriate shocks, may improve battery longevity in long-term follow-up of patients implanted with an ICD and is as safe as, sometimes even safer than, standard in-office follow-ups. The outcome was consistent with previous findings from studies such as the landmark TRUST trial.
The ECOST trial
ECOST is a prospective multicentre clinical trial which was designed to examine the safety and efficacy of remote monitoring of ICD patients with Home Monitoring over 27 months. The study analysed 433 patients from 43 sites throughout France who were randomly assigned to home monitoring follow-up or standard in-office care. The 221 home monitoring patients (the active group) were seen in the ambulatory department once per year, unless home monitoring reported a technical or clinical event requiring an in-office visit. The 212 control group patients underwent in-office visits every six months.
During a two-year period, the overall number of delivered shocks in the home monitoring group was 71% lower than in the control group which was a significant decrease. Furthermore, the proportion of patients who received inappropriate shocks was 52% lower in the home monitoring group than in the control group. While some remote monitoring technologies can drain the device battery in the long term, daily Home Monitoring retains ICD battery life: ECOST showed a 76% reduction in the number of capacitor charges for the Home Monitoring group (499 vs. 2081), which resulted in extended device longevity.
“The ECOST trial results prove Home Monitoring reduces inappropriate shocks in patients and also positively extends the ICD’s battery longevity,” said Salem Kacet, principal investigator of the ECOST study. “This advanced technology is very important for the observation of arrhythmias and early adaptation of ICD therapy. Patients benefit from the reduced risk of inappropriate shocks-which can be a very unpleasant experience-and need ICD replacement less frequently.”
“Developing safe, innovative, effective therapies to improve patient health is Biotronik’s number one priority,” said Christoph Böhmer, president international of Biotronik. “By conducting landmark trials like ECOST, we are providing definitive answers to questions and challenges physicians face in their practices. In addition, we are making significant contributions to the field of cardiac rhythm therapy research. Home Monitoring enhances the patient’s quality of life and simplifies patient treatment.”
Biotronik’s Home Monitoring
Home Monitoring is a remote patient management system. The system allows continuous, automatic, wireless remote monitoring of patient status and device status with daily updates independent of any patient interaction. The technology leads to earlier intervention, as proven by the results of the TRUST landmark trial. Biotronik’s Home Monitoring is used in more than 5300 clinics and 56 countries worldwide.