Remote monitoring may detect clinical events more quickly and reduce inappropriate shocks when compared to in-office follow-up, according to the results of a study published in the Journal of the American College of Cardiology (JACC).

In a meta-analysis of nine randomized controlled trials, researchers compared the clinical outcomes in patients with implantable cardioverter-defibrillators (ICD) who were remotely monitored (3,496) to those who had in-office follow-ups (2,973). Clinical outcomes included all-cause mortality, hospitalizations, unscheduled visits, shock delivery and atrial fibrillation.

The results of the study showed a significant benefit to ICD patient mortality when using daily verification of remote monitoring transmission. They also indicated the potential for remote monitoring to minimize ICD shocks and other adverse outcomes by identifying clinical events earlier through continuous surveillance. While patients receiving in-office follow-up and those remotely monitored experienced similar rates of clinical outcomes, researchers said the study provides further evidence on the safety and non-inferiority of remote monitoring.

A related study, also published in JACC, found remote monitoring was also associated with higher rates of survival. The retrospective observational cohort study, analyzed the type of cardiac device in 269,471 patients to determine any differences in mortality or degree of utilization. Patients were implanted with pacemakers, ICDs or cardiac resynchronization therapy pacemakers/defibrillators with wireless remote monitoring.

Researchers found that patients who spent any time in remote monitoring had higher rates of survival than those who did not use remote monitoring at all. Further, the study results showed that higher numbers of transmissions in remote monitoring were associated with lower mortality rates compared to lower numbers of transmissions.

While the mortality benefits of remote monitoring did not differ between the devices, the authors of the study note that patients must actually utilize remote monitoring in order to benefit from it.

“Cardiac implantable devices are in the vanguard of the personal ‘big data’ revolution,” said James V. Freeman, MD, MPH, and Leslie Saxon, MD, FACC, in an accompanying editorial comment to both studies. “It is imperative that we continue to improve the quality and use of the data they generate to best meet the needs and optimize the outcomes of patients and enable physicians to practice most efficiently.”

Keywords: Atrial Fibrillation, Cardiac Resynchronization Therapy, Defibrillators, Implantable, Follow-Up Studies, Hospitalization, Monitoring, Physiologic, Shock, Survival Rate

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