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Remote Monitoring of Implantable Cardioverter Defibrillators versus Quarterly Device Interrogations in Clinic: Results from a Randomized Pilot Clinical Trial
Abstract
ICD: Remote Monitoring Versus Clinic Interrogations. Introduction:Remote monitoring is increasingly becoming the new standard of care for implantable cardioverter defibrillator (ICD) follow‐up. We sought to determine whether remote monitoring of ICDs improves patient outcomes compared with quarterly device interrogations in clinic. Methods and Results:In this single‐center pilot clinical trial, adult patients with an ICD were randomly assigned to remote monitoring versus quarterly device interrogations in clinic. The primary endpoint was a composite of cardiovascular hospitalization, emergency room visit for a cardiac cause, and unscheduled visit to the electrophysiology clinic for a device‐related issue at 1 year. We also examined health‐related quality of life, costs, and patient satisfaction with their ICD care. Of 151 patients enrolled in this trial, 76 were randomized to remote monitoring and 75 to quarterly device interrogations in clinic. There was no significant difference in the primary endpoint (32% in the remote monitoring arm vs 34% in the control arm; P = 0.8), mortality, or cost between the 2 arms. Quality of life and patient satisfaction were significantly better in the control arm than in the remote monitoring arm at 6 months (83 [25th, 75th percentiles 70, 90] vs 75 [50, 85]; P = 0.002 and 88 [75, 100] vs 75 [75, 88]; P = 0.03, respectively), but not at 12 months. Conclusion:We showed no significant reduction in cardiac‐related resource utilization with remote monitoring of ICDs. However, given the small number of patients in our study, the real clinical and health economics impact of remote monitoring needs to be verified by a large, multicenter, randomized clinical trial.(J Cardiovasc Electrophysiol, Vol. 21, pp. 545‐550, May 2010)
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“Data on the cost benefits of remote monitoring are not definitive to date.52,56”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [56]
Citations
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Amiodarone or an Implantable Cardioverter–Defibrillator for Congestive Heart Failure
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Self-citationThe Effect of Cardiac Resynchronization on Morbidity and Mortality in Heart Failure
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Research works printed but not linked: 2
- 10.1016/j.ahj.2007.07.051 · DOI
- 10.1111/j.1540-8159.2008.01175.x · DOI · Paper page
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“10,11 These systems use a wand-based radiofrequency platform to transfer data between the patient ’ s device and a transceiver.”
MethodRemote Monitoring of Implantable Cardioverter-Defibrillators
Parthiban, N., Esterman, A., Mahajan, R., Twomey, D. J., Pathak, R. K., Lau, D. H., Roberts‐Thomson, K. C., Young, G. D., Sanders, P., & Ganesan, A. N. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.04.029 · Cited by 247
“, 2010 (15) Single $18 yrs of age, have an ICD with or without CRT for an approved indication, devices followed-up at center, must have a telephone (land line) Patient-initiated transmissions every 3 months plus IO visit at 12 months IO visit every 3 months”
BackgroundBoriani, G., Costa, A. D., Quesada, A., Ricci, R. P., Favale, S., Boscolo, G., Clémenty, N., Amori, V., Stefano, L. M. D. S., & Burri, H. (2016) · European Journal of Heart Failure · doi:10.1002/ejhf.626 · Cited by 213
“Results related to costs for healthcare resource utilization are variable: Fauchier, 25 Raatikainen, 23 Zanaboni, 24 and Guédon-Moreau 26 reported or assumed savings (due to reduced visits or hospitalizations, and/or reimbursed transports), whereas Al-Khatib, 27 Burri, 28 and Heidbuchel 22 did not.”
Shameer, K., Badgeley, M. A., Miotto, R., Glicksberg, B. S., Morgan, J. W., & Dudley, J. T. (2017) · Briefings in Bioinformatics · doi:10.1093/bib/bbv118 · Cited by 198
Metadata
- Authors
- AL‐KHATIB, S. M., PICCINI, J. P., KNIGHT, D., STEWART, M., CLAPP‐CHANNING, N., & SANDERS, G. D.
- Affiliations
- Duke Medical Center (US)
- Duke Clinical Research Institute (US)
- Venue
- Journal of Cardiovascular Electrophysiology
- Publisher
- Wiley
- Published
- 2010-04-15
- Volume
- 21
- Issue
- 5
- Pages
- 545-550
- ISSN
- 1045-3873 (ISSN-L)
- 1540-8167
- OpenAlex
- W2086481724
- Cited by
- 114
- References
- 18
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 8 · 2019: 5 · 2018: 4 · 2017: 8 · 2016: 11 · 2015: 8 · 2014: 12 · 2013: 16 · 2012: 9
- FWCI
- 4.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiovascular Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Keywords
- implantable cardioverter-defibrillator, remote monitoring, device interrogation, ICD follow-up, health-related quality of life, patient satisfaction, health care costs, resource utilization (health care), cardiovascular hospitalization, emergency department visits
- MeSH terms
- Aged, Anti-Arrhythmia Agents, Arrhythmias, Cardiac, Cost-Benefit Analysis, Cost Control, Female, Humans, Male, Middle Aged, Monitoring, Physiologic, Office Visits, Pilot Projects, Quality of Life, Telephone, Treatment Outcome, Patient Satisfaction, Defibrillators, Implantable, Endpoint Determination
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