{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:33:42Z","timestamp":1787960022016,"version":"build-2784847793"},"reference-count":39,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:00:00Z","timestamp":1605830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Centre for Research and Development, Warsaw, Poland","award":["Grant number STRATEGMED1\/233547\/13\/NCBR\/2015"],"award-info":[{"award-number":["Grant number STRATEGMED1\/233547\/13\/NCBR\/2015"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The impact of cardiac rehabilitation on the number of alerts in patients with remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) is unknown. We compared alerts in RM and outcomes in patients with CIEDs undergoing hybrid comprehensive telerehabilitation (HCTR) versus usual care (UC). Methods: Patients with heart failure (HF) after a hospitalization due to worsening HF within the last 6 months (New York Heart Association (NYHA) class I-III and left ventricular ejection fraction (LVEF) \u226440%) were enrolled in the TELEREH-HF study and randomised 1:1 to HCTR or UC. Patients with HCTR and CIEDs received RM (HCTR-RM). Patients with UC and CIEDs were offered RM optionally (UC-RM). Data from the initial 9 weeks of the study were analysed. Results: Of 850 enrolled patients, 208 were in the HCTR-RM group and 62 in the UC-RM group. The HCTR-RM group was less likely to have alerts of intrathoracic impedance (TI) decrease (p &lt; 0.001), atrial fibrillation (AF) occurrence (p = 0.031) and lower mean number of alerts per patient associated with TI decrease (p &lt; 0.0001) and AF (p = 0.019) than the UC-RM group. HCTR significantly decreased the occurrence of alerts in RM of CIEDs, 0.360 (95%CI, 0.189\u20130.686; p = 0.002), in multivariable regression analysis. There were two deaths in the HCTR-RM group (0.96%) and no deaths in the UC-RM group (p = 1.0). There were no differences in the number of hospitalised patients between the HCTR-RM and UC-RM group (p = 1.0). Conclusions: HCTR significantly reduced the number of patients with RM alerts of CIEDs related to TI decrease and AF occurrence. There were no differences in mortality or hospitalisation rates between HCTR-RM and UC-RM groups.<\/jats:p>","DOI":"10.3390\/jcm9113729","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T09:46:18Z","timestamp":1605865578000},"page":"3729","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Remote Monitoring of Cardiac Implantable Electronic Devices in Patients Undergoing Hybrid Comprehensive Telerehabilitation in Comparison to the Usual Care. Subanalysis from Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomised Clinical Trial"],"prefix":"10.3390","volume":"9","author":[{"given":"S\u0142awomir","family":"Pluta","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, Silesian Centre for Heart Disease, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Piotrowicz","sequence":"additional","affiliation":[{"name":"Telecardiology Center, National Institute of Cardiology, 04-628 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9571-1694","authenticated-orcid":false,"given":"Ryszard","family":"Piotrowicz","sequence":"additional","affiliation":[{"name":"National Institute of Cardiology, 04-628 Warsaw, Poland"},{"name":"Warsaw Academy of Medicine Rehabilitation, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0162-2659","authenticated-orcid":false,"given":"Ewa","family":"Lewicka","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Electrotherapy, Medical University of Gda\u0144sk, 80-211 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Zare\u0328ba","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0384-1975","authenticated-orcid":false,"given":"Monika","family":"Kozie\u0142","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Silesian Centre for Heart Disease, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilona","family":"Kowalik","sequence":"additional","affiliation":[{"name":"National Institute of Cardiology, 04-628 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Pencina","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC 27707, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artur","family":"Or\u0119ziak","sequence":"additional","affiliation":[{"name":"Department of Arrhythmia, National Institute of Cardiology, 04-628 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Cacko","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominika","family":"Szalewska","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine, Medical University of Gda\u0144sk, 80-211 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"G\u0142\u00f3wczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Warsaw, 02-091Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6690-6874","authenticated-orcid":false,"given":"Maciej","family":"Banach","sequence":"additional","affiliation":[{"name":"Department of Hypertension, Medical University of \u0141\u00f3d\u017a, 92-213 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Opolski","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Warsaw, 02-091Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Orzechowski","sequence":"additional","affiliation":[{"name":"Telecardiology Center, National Institute of Cardiology, 04-628 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Irzma\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiac Rehabilitation, Medical University of \u0141\u00f3d\u017a, 92-213 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zbigniew","family":"Kalarus","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Division of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_2","first-page":"Cd011273","article-title":"Cardiac rehabilitation for people with heart disease: An overview of Cochrane systematic reviews","volume":"2014","author":"Anderson","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1177\/2047487312449597","article-title":"Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: A policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology","volume":"21","author":"Piepoli","year":"2014","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1111\/j.1540-8159.2000.tb00878.x","article-title":"Assessing the psychosocial impact of the ICD: A national survey of implantable cardioverter defibrillator health care providers","volume":"23","author":"Sears","year":"2000","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_5","first-page":"117","article-title":"Fear of exercise and health-related quality of life in patients with an implantable cardioverter defibrillator","volume":"26","author":"Coster","year":"2003","journal-title":"Int. J. Rehabil. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1161\/CIRCULATIONAHA.114.014444","article-title":"Prospective randomized trial of moderately strenuous aerobic exercise after an implantable cardioverter defibrillator","volume":"131","author":"Dougherty","year":"2015","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1177\/2047487314551537","article-title":"Home-based telemonitored Nordic walking training is well accepted, safe, effective and has high adherence among heart failure patients, including those with cardiovascular implantable electronic devices: A randomised controlled study","volume":"22","author":"Piotrowicz","year":"2015","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.jchf.2013.01.005","article-title":"Exercise training and implantable cardioverter-defibrillator shocks in patients with heart failure: Results from HF-ACTION (Heart Failure and A Controlled Trial Investigating Outcomes of Exercise TraiNing)","volume":"1","author":"Piccini","year":"2013","journal-title":"JACC Heart Fail."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1093\/europace\/eux373","article-title":"Antiarrhythmic drugs-clinical use and clinical decision making: A consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group on Cardiovascular Pharmacology, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS) and International Society of Cardiovascular Pharmacotherapy (ISCP)","volume":"20","author":"Dan","year":"2018","journal-title":"Europace"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1093\/eurheartj\/ehs425","article-title":"A randomized study of remote follow-up of implantable cardioverter defibrillators: Safety and efficacy report of the ECOST trial","volume":"34","author":"Lacroix","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1161\/CIRCULATIONAHA.110.937409","article-title":"Efficacy and safety of automatic remote monitoring for implantable cardioverter-defibrillator follow-up: The Lumos-T Safely Reduces Routine Office Device Follow-up (TRUST) trial","volume":"122","author":"Varma","year":"2010","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/j.jacc.2010.12.012","article-title":"The CONNECT (Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision) trial: The value of wireless remote monitoring with automatic clinician alerts","volume":"57","author":"Crossley","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2985","DOI":"10.1161\/CIRCULATIONAHA.111.088971","article-title":"Remote monitoring reduces healthcare use and improves quality of care in heart failure patients with implantable defibrillators: The evolution of management strategies of heart failure patients with implantable defibrillators (EVOLVO) study","volume":"125","author":"Landolina","year":"2012","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2359","DOI":"10.1161\/CIRCULATIONAHA.110.960633","article-title":"Long-term outcome after ICD and CRT implantation and influence of remote device follow-up: The ALTITUDE survival study","volume":"122","author":"Saxon","year":"2010","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1093\/eurheartj\/ehx015","article-title":"Daily remote monitoring of implantable cardioverter-defibrillators: Insights from the pooled patient-level data from three randomized controlled trials (IN-TIME, ECOST, TRUST)","volume":"38","author":"Hindricks","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.ahj.2019.08.015","article-title":"Hybrid comprehensive telerehabilitation in heart failure patients (TELEREH-HF): A randomized, multicenter, prospective, open-label, parallel group controlled trial-Study design and description of the intervention","volume":"217","author":"Piotrowicz","year":"2019","journal-title":"Am. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1001\/jamacardio.2019.5006","article-title":"Effects of a 9-Week Hybrid Comprehensive Telerehabilitation Program on Long-term Outcomes in Patients With Heart Failure: The Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomized Clinical Trial","volume":"5","author":"Piotrowicz","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e2949","DOI":"10.1097\/MD.0000000000002949","article-title":"Digoxin Use and Adverse Outcomes in Patients with Atrial Fibrillation","volume":"95","author":"Zeng","year":"2016","journal-title":"Medicine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.ijcard.2016.04.036","article-title":"Underweight is a risk factor for atrial fibrillation: A nationwide population-based study","volume":"215","author":"Kang","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1136\/heartjnl-2014-307015","article-title":"Higher circulating adiponectin levels are associated with increased risk of atrial fibrillation in older adults","volume":"101","author":"Macheret","year":"2015","journal-title":"Heart"},{"key":"ref_21","first-page":"1","article-title":"A novel transgenic mouse model of cardiac hypertrophy and atrial fibrillation","volume":"2","author":"Rosenberg","year":"2012","journal-title":"J. Atr. Fibrillation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1161\/CIRCULATIONAHA.104.492207","article-title":"Intrathoracic impedance monitoring in patients with heart failure: Correlation with fluid status and feasibility of early warning preceding hospitalization","volume":"112","author":"Yu","year":"2005","journal-title":"Circulation"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/j.1751-7133.2011.00220.x","article-title":"Intrathoracic impedance vs daily weight monitoring for predicting worsening heart failure events: Results of the Fluid Accumulation Status Trial (FAST)","volume":"17","author":"Abraham","year":"2011","journal-title":"Congest. Heart Fail."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2266","DOI":"10.1093\/eurheartj\/ehr050","article-title":"Sensitivity and positive predictive value of implantable intrathoracic impedance monitoring as a predictor of heart failure hospitalizations: The SENSE-HF trial","volume":"32","author":"Conraads","year":"2011","journal-title":"Eur. Heart J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jelectrocard.2019.01.004","article-title":"Evaluation of thoracic impedance trends for implant-based remote monitoring in heart failure patients\u2014Results from the (J-)HomeCARE-II Study","volume":"53","author":"Maier","year":"2019","journal-title":"J. Electrocardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1097\/01.hjr.0000209810.59831.f4","article-title":"Reduction of N terminal-pro-brain (B-type) natriuretic peptide levels with exercise-based cardiac rehabilitation in patients with left ventricular dysfunction after myocardial infarction","volume":"13","author":"Giallauria","year":"2006","journal-title":"Eur. J. Cardiovasc. Prev. Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1177\/2047487317705488","article-title":"Effects of a cardiac rehabilitation programme on plasma cardiac biomarkers in patients with chronic heart failure","volume":"24","author":"Billebeau","year":"2017","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Piotrowicz, E., Mierzy\u0144ska, A., Banach, M., Jaworska, I., Pencina, M., Kowalik, I., Pluta, S., Szalewska, D., Opolski, G., and Zar\u0119ba, W. (2020). Quality of life in heart failure patients undergoing hybrid comprehensive telerehabilitation versus usual care\u2014Results of the Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomized Clinical Trial. Arch. Med. Sci., 16.","DOI":"10.5114\/aoms.2020.98350"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Hsu, C.-C., Fu, T.-C., Yuan, S.-S., Wang, C.-H., Liu, M.-H., Shyu, Y.-C., Cherng, W.-J., and Wang, J.-S. (2019). High-Intensity Interval Training is Associated with Improved Long-Term Survival in Heart Failure Patients. J. Clin. Med., 8.","DOI":"10.3390\/jcm8030409"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1093\/europace\/eus440","article-title":"Effectiveness of remote monitoring of CIEDs in detection and treatment of clinical and device-related cardiovascular events in daily practice: The HomeGuide Registry","volume":"15","author":"Ricci","year":"2013","journal-title":"Europace"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1161\/CIRCULATIONAHA.115.018220","article-title":"Aerobic Interval Training Reduces the Burden of Atrial Fibrillation in the Short Term: A Randomized Trial","volume":"133","author":"Malmo","year":"2016","journal-title":"Circulation"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2987","DOI":"10.1093\/eurheartj\/ehx739","article-title":"Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: Results of the RACE 3 trial","volume":"39","author":"Rienstra","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1016\/j.jacc.2017.01.032","article-title":"Exercise Training in Patients With Chronic Heart Failure and Atrial Fibrillation","volume":"69","author":"Luo","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1161\/CIRCULATIONAHA.116.023163","article-title":"Modifiable Risk Factors and Atrial Fibrillation","volume":"136","author":"Lau","year":"2017","journal-title":"Circulation"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Cicho\u0144, M., Mizia-Szubryt, M., Olszanecka-Glinianowicz, M., Bo\u017centowicz-Wikarek, M., Owczarek, A.J., Rafa\u0142 Michalik, R., and Mizia-Stec, K. (2020). Biomarkers of left atrial overload in obese and non-obese patients with atrial fibrillation qualified for electrical cardioversion. Kardiol. Pol.","DOI":"10.33963\/KP.15673"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1016\/j.jacc.2015.06.488","article-title":"Impact of CARDIOrespiratory FITness on Arrhythmia Recurrence in Obese Individuals with Atrial Fibrillation: The CARDIO-FIT Study","volume":"66","author":"Pathak","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_37","first-page":"193","article-title":"Dysfunction of the autonomic nervous system in atrial fibrillation","volume":"7","author":"Xi","year":"2015","journal-title":"J. Thorac. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1093\/eurheartj\/15.suppl_A.9","article-title":"Paroxysmal atrial fibrillation: A disorder of autonomic tone?","volume":"15","author":"Coumel","year":"1994","journal-title":"Eur. Heart J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/S0735-1097(03)00831-3","article-title":"The effects of exercise training on sympathetic neural activation in advanced heart failure: A randomized controlled trial","volume":"42","author":"Roveda","year":"2003","journal-title":"J. Am. Coll. Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/11\/3729\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:34:51Z","timestamp":1760178891000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/11\/3729"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,20]]},"references-count":39,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["jcm9113729"],"URL":"https:\/\/doi.org\/10.3390\/jcm9113729","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,20]]}}}