Ewa Piotrowicz:    This trial was conducted in Poland in 5 centers. We randomized 850 heart failure patients with left ventricle ejection fraction below 40%, 6 months after hospitalization. The patients were randomized in a one-to-one ratio to telemanagement for 9 weeks or usual care. The telemanagement consisted of telecare, telerehabilitation, and home monitoring of implantable electronic devices. After these nine weeks, we observed significant improvement in physical capacity and quality of life in the telemanagement group, and we did not observe such viable effects in the usual care group. After 9 weeks, the intervention was completed, and patients were followed for the next 2 years. After the intervention was completed, it is important because if we look at this slide, we can see that the adherence to telemedical management was very high, above 80%, 88%, and patients who adhered to this intervention could translate the healthy behavior through the next two years. And it affected the prognosis because only in the adherent patients’ group we reduced significantly cardiovascular mortality, and combined endpoint consisted of all-cause mortality or heart failure hospitalization, and cardiovascular mortality or heart failure hospitalization.

 In other words, after completing the intervention, patients followed healthy behavior. So, it is very promising information for telemedical solutions. This intervention was also cost-effective.