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Remote monitoring of implanted devices reduced time between onset of events, clinical decision-making
Remote management also associated with positive changes in health care utilization.
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American College of Cardiology 59th Annual Scientific Sessions
ATLANTA – A wireless remote monitoring and notification system based on cardiac resynchronization therapy defibrillators and implantable cardioverter defibrillators cut the time from onset of events to clinical decisions in response to arrhythmias, CVD progression and device issues by nearly two-thirds, as compared with standard in-office care.
The CONNECT study compared standard in-office care with a wireless telemetry system in 1,997 patients implanted with an ICD or cardiac resynchronization defibrillator. Patients assigned to remote monitoring received a home monitor capable of receiving a wireless telemetry system from the implanted device and automatically transmitting diagnostic information to the office over the phone, including routine scheduled information and alerts, requiring no patient action (n=1,014; 70.5% men; mean age, 65.2 years). These patients were seen in the office one month and 15 months after device implantation only. Patients assigned to standard care were followed-up in the office on a fixed schedule, typically every three to six months, and received no remote monitoring (n=983; 71.7% men; mean age, 64.9 years).
Remote monitoring decreased the time from between onset of events to clinical decision making, a mean 10.5 days compared with 29.5 days with standard in-office care.
Patients assigned to remote monitoring also experienced significant reductions in the average length of hospital stay (3.3 days vs. 4 days) compared with standard care. Replacement of routine in-clinic follow-up visits with remote transmissions did not increase other health care utilizations, such as CV hospitalizations and ED and unscheduled clinic visits. These improvements were associated with an average estimated savings of $1,659 per hospitalization for patients who received remote monitoring.
“This system allows the clinician to better manage the patient’s disease by making critical information immediately available,” George H. Crossley, MD, president of Mid-State Cardiology and clinical professor of medicine at the University of Tennessee College of Medicine, both in Nashville, TN, said in a press release. “By learning about clinical events earlier, we have the opportunity to intervene earlier, improve outcome and prevent disease progression.”
CONNECT enrolled patients from 2006 to 2008; patient follow-up was completed in 2009. This study was funded by Medtronic, Inc.
For more information:
- Crossley GH. LBCT II. Presented at: American College of Cardiology 59th Annual Scientific Sessions; March 13-16, 2010; Atlanta.
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