Can monitoring of intrathoracic impedance reduce morbidity and mortality in patients with chronic heart failure? Rationale and design of the Diagnostic Outcome Trial in Heart Failure (DOT-HF)

Braunschweig, F. et al. (2008) Can monitoring of intrathoracic impedance reduce morbidity and mortality in patients with chronic heart failure? Rationale and design of the Diagnostic Outcome Trial in Heart Failure (DOT-HF). European Journal of Heart Failure, 10(9), pp. 907-916. (doi: 10.1016/j.ejheart.2008.06.016)

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Publisher's URL: http://dx.doi.org/10.1016/j.ejheart.2008.06.016

Abstract

<p><b>Background:</b> Chronic heart failure is associated with frequent hospitalisations which are often due to volume-overload decompensation. Monitoring of intrathoracic impedance, measured from an implanted device, can detect increases in pulmonary fluid retention early and facilitate timely treatment interventions.</p> <p><b>Objective:</b> The DOT-HF trial is designed to investigate if ambulatory monitoring of intrathoracic impedance together with other device-based diagnostic information can reduce morbidity and mortality in patients with chronic heart failure who are treated with cardiac resynchronization therapy (CRT) and/or an implantable defibrillator (ICD).</p> <p><b>Methods:</b> Approximately 2400 patients will be randomised in a 1:1 fashion to a management strategy with access to the diagnostic information from the implantable device (“access arm”), or a “control arm”, where this information is not made available. Study subjects fulfil standard indications for CRT and/or ICD as outlined in current guidelines. In the access arm, a fluid alert algorithm is used to give early warning of decreasing intrathoracic impedance indicating a high risk of an impending volume-overload decompensation. The primary endpoint of DOT-HF is the composite of all-cause mortality or heart failure hospitalisation. Secondary and exploratory endpoints include all-cause mortality, the impact on total health care utilization, quality of life and cost effectiveness. The study is expected to close recruitment during 2010 and to report in 2012.</p>

Item Type:Articles (Editorial)
Keywords:DOT-HF trial; Congestive heart failure; Monitoring; Cardiac resynchronization; Implantable defibrillator; Bioimpedance
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Ford, Professor Ian
Authors: Braunschweig, F., Ford, I., Conraads, V., Cowie, M., Jondeau, G., Kautzner, J., Lunati, M., Munoz Aguilera, R., Man Yu, C., Marijianowski, M., Borggrefe, M., and van Veldhuisen, D.J.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
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Journal Name:European Journal of Heart Failure
Publisher:Oxford University Press
ISSN:1388-9842
ISSN (Online):1879-0844
Published Online:01 January 2008

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