Published in:
01-10-2017 | Original Paper
Activation of remote monitoring for cardiac implantable electronic devices: small dog for tall weeds
Authors:
Giuseppe D’Ancona, Erdal Safak, Jochen Senges, Matthias Hochadel, Van Luyen Nguyen, Christian Perings, Werner Jung, Stefan Spitzer, Lars Eckardt, Johannes Brachmann, Karlheinz Seidl, Hans Ulrich Hink, Hüseyin Ince, Jasmin Ortak
Published in:
Clinical Research in Cardiology
|
Issue 10/2017
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Abstract
Background
Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) has been popularized as a precious patients’ management tool. We have investigated RM within the premises of a multicenter, prospective, real-world registry, i.e., the German Device II.
Methods
We have focused on: (1) CIEDs with RM capabilities implantation rate and (2) actual rate of RM features activation.
Results
A cohort of 1223 CIEDs patients were treated from 04/11 to 02/14. Of these, 720 (58.8%) were implanted with RM-capable devices and were presenting significantly more often a clinical diagnosis of dilatative cardiomyopathy and an indication for cardiac resynchronization. At discharge, the RM feature was activated in only 12.6% (91/720) of the total number of patients implanted with RM-capable CIEDs. After adjusting for implanting center, there was no significant correlation between any of the patient clinical characteristics and RM activation. One-year estimated mortality was 9.0% in patients with activated RM, 5.6% in those with not activated RM, and 7.7% in those without RM capability (p = 0.3). The RM feature was still activated in 13.8% of the patients surviving at follow-up. Patients undergoing RM had a trend for higher re-hospitalization rate and less visits in the device outpatient clinic.
Conclusions
Although RM in CIEDs may be a clinically valuable technological armamentarium, its activation does not reflect patients’ clinical profile. In fact, RM is often not activated, most probably because it is still recognized as a source of increased workload in a reality where reimbursement plans for dedicated human resources are not yet optimized.