Study Demonstrates Benefits of Remote Monitoring in Improving ICD Patient Outcomes Unique Research Collaboration Could Be Model for Future Studies
First-time patients with implantable cardioverter defibrillators (ICD) who used wireless remote patient monitoring had significantly lower risks of death and rehospitalization compared with those who did not, according to a study presented as part of Heart Rhythm 2014.
The study, a unique research collaboration between Yale University, the ACC and Boston Scientific, combined data from the Boston Scientific ALTITUDE Registry and the ACC’s ICD Registry and looked at first-time ICD implants performed between January 2006 and March 2010 (n=37,742 not, age 67±13, 72 percent male). Vital status was determined using the Social Security Death Master File. All cause mortality up to three years was compared in patients who used remote monitoring and those who did.
Overall, the study cohort had a three-year mortality of 20.9 percent after a median follow-up of 832 days. A total of 22,023 patients transmitted data using remote monitoring within three years of their ICD implantation. In multivariable analyses, patients who used remote monitoring consistently had lower mortality risk compared with those who did not (HR 0.67, 95% CI 0.64-0.70, p<0.0001). In addition, the all-cause rehospitalization risk of patients who used remote monitoring services was significantly lower than that of patients who did not use remote monitoring (HR 0.81, 95% CI 0.79-0.83, p<0.0001).
According to study investigators, the findings provide evidence supporting broader use of remote monitoring technology to improve patient outcomes. Currently remote monitoring is not uniformly used in practice and less than 50 percent of eligible patients use it, they said. Moving forward they suggest that the results could be used to inform guidelines and increase adoption of remote monitoring.
Meanwhile, ACC President Patrick T. O’Gara, MD, FACC, noted that the unique research collaboration could be used as a new model for research going forward. "The ACC appreciated the opportunity to collaborate with Yale University researchers and Boston Scientific on this unique observational study that not only suggests remote patient monitoring is effective and should be used more widely, but also demonstrates the powerful and synergistic effect of combining data from industry, the federal government and clinical registries to improve patient outcomes," he said. "It is our hope that this study can be used as a model for future research projects that utilize a combination of data sources, including clinical registries such as those under the ACC’s National Cardiovascular Data Registry umbrella, as well as health care analytics, to inform guidelines and better target patient care."
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