Clinical Benefits of Remote Versus Transtelephonic Monitoring of Implanted Pacemakers

Crossley, George H.; Chen, Jane; Choucair, Wassim; Cohen, Todd J.; Gohn, Douglas C.; Johnson, W. Ben; Kennedy, Eleanor E.; Mongeon, Luc R.; Serwer, Gerald A.; Qiao, Hongyan; Wilkoff, Bruce L.

doi:10.1016/j.jacc.2009.10.001

Cited by 202Cardiac pacing and defibrillation studiesECG Monitoring and AnalysisTelemedicine and Telehealth Implementation

Clinical Benefits of Remote Versus Transtelephonic Monitoring of Implanted Pacemakers

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Crossley, George H., Chen, Jane, Choucair, Wassim, Cohen, Todd J., Gohn, Douglas C., Johnson, W. Ben, Kennedy, Eleanor E., Mongeon, Luc R. +3 more·2009·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2009.10.001

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Abstract

Objectives The purpose of this study was to evaluate remote pacemaker interrogation for the earlier diagnosis of clinically actionable events compared with traditional transtelephonic monitoring and routine in-person evaluation.Background Pacemaker patient follow-up procedures have evolved from evaluating devices with little programmability and diagnostic information solely in person to transtelephonic rhythm strip recordings that allow monitoring of basic device function. More recently developed remote monitoring technology leverages expanded device capabilities, augmenting traditional transtelephonic monitoring to evaluate patients via full device interrogation.Methods The time to first diagnosis of a clinically actionable event was compared in patients who were followed by remote interrogation (Remote) and those who were followed per standard of care with office visits augmented by transtelephonic monitoring (Control). Patients were randomized 2:1. Remote arm patients transmitted pacemaker information at 3-month intervals. Control arm patients with a single-chamber pacemaker transmitted at 2-month intervals. Control arm patients with dual-chamber devices transmitted at 2-month intervals with an office visit at 6 months. All patients were seen in office at 12 months.Results The mean time to first diagnosis of clinically actionable events was earlier in the Remote arm (5.7 months) than in the Control arm (7.7 months). Three (2%) of the 190 events in the Control arm and 446 (66%) of 676 events in the Remote arm were identified remotely.Conclusions The strategic use of remote pacemaker interrogation follow-up detects actionable events that are potentially important more quickly and more frequently than transtelephonic rhythm strip recordings. The use of transtelephonic rhythm strips for pacemaker follow-up is of little value except for battery status determinations. (PREFER [Pacemaker Remote Follow-up Evaluation and Review]; NCT00294645).

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In the PREFER trial, clinically actionable events such as atrial arrhythmias, increase in right ventricular pacing, lead function changes, and battery depletion were detected earlier in the remote-monitoring arm.
“In the Pacemaker Remote Follow-up Evaluation and Review (PREFER) trial, which randomly assigned 980 PM patients to follow-up with remote monitoring versus in-office visits plus transtelephonic monitoring, clinically actionable events such as atrial arrhythmias, increase in right ventricular pacing, lead function changes, and battery depletion, were detected earlier in the remote-monitoring arm.57”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [57]
The Abstract and participant-flow/results section report that clinically actionable events were detected earlier in the remote arm (mean 5.7 versus 7.7 months). However, the Clinically Actionable Events table says lead-function changes and battery-depletion indicators were not used in the analysis because events were too few to establish earlier detection for those categories. The participant-flow section also says 980 patients were screened, but only 897 were randomized. (LLM, conf=0.91)
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Intérêt du télésuivi automatisé des stimulateurs cardiaques
Marchand, H. (2018) · HAL

Authors: Crossley, G. H., Chen, J., Choucair, W., Cohen, T. J., Gohn, D. C., Johnson, W. B., Kennedy, E. E., Mongeon, L. R., Serwer, G. A., Qiao, H., & Wilkoff, B. L.
Affiliations: University of Tennessee at Knoxville (US)
Washington University in St. Louis (US)
Winthrop-University Hospital (US)
Arkansas Heart Hospital (US)
Medtronic (United States) (US)
University of Michigan (US)
Cleveland Clinic (US)
Corresponding author: Crossley, George H.
ORCID: Crossley, George H.
Chen, Jane
Cohen, Todd J.
Wilkoff, Bruce L.
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2009-11
Volume: 54
Issue: 22
Pages: 2012-2019
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2009.10.001
OpenAlex: W1989653793
Cited by: 202
References: 19
Citations by year: 2026: 3 · 2025: 3 · 2024: 2 · 2023: 11 · 2022: 5 · 2021: 13 · 2020: 12 · 2019: 9 · 2018: 11 · 2017: 11 · 2016: 14 · 2015: 18 · 2014: 11 · 2013: 27 · 2012: 27
FWCI: 11.21
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 1390 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
Funders: Medtronic
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords: transtelephonic monitoring, implantable pacemaker, pacemaker follow-up, time to diagnosis, remote monitoring, device interrogation, battery status, single-chamber pacemaker, dual-chamber pacemaker
MeSH terms: Aged, Aged, 80 and over, Arrhythmias, Cardiac, Coronary Artery Disease, Diabetic Angiopathies, Female, Heart Failure, Humans, Male, Middle Aged, Monitoring, Physiologic, Office Visits, Pacemaker, Artificial, Prospective Studies, Telemetry, Telephone, Time Factors, Comorbidity

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Clinical Benefits of Remote Versus Transtelephonic Monitoring of Implanted Pacemakers

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