Remote monitoring of implanted devices with a universal platform improves outcomes
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Key takeaways:
- A universal remote monitoring platform was associated with lower mortality and fewer hospitalizations than conventional systems.
- The system uses artificial intelligence to glean the most important data.
Use of a third-party universal remote monitoring platform was linked to better survival and hospitalization outcomes than conventional remote monitoring or no monitoring in patients with implanted cardiac devices, researchers reported.
A retrospective analysis of 68,787 patients (mean age, 68 years; 77% men) with an implantable cardioverter defibrillator or cardiac resynchronization therapy defibrillator from a French national health database was presented at Heart Rhythm 2023. It compared patients who had remote monitoring with those who did not, and compared those who had remote monitoring with conventional systems with those who had remote monitoring with the third-party universal platform (Implicity, Implicity) that does not require clinical resources to maintain the monitoring but provides direction to clinicians.
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“Most of the time, manufacturers’ platforms are used for remote monitoring of manufacturers’ devices,” Arnaud Rosier, MD, PhD, CEO and co-founder of Implicity, who was an author of the study, told Healio. “Those have been around for 20 years and are beneficial to patients, but they are hard to manage because of limited data and false positives. There are now third-party platforms on the market. We are trying to provide a universal platform which gathers the discrete data from all devices of all manufacturers, puts it all in one place, and on top of that uses medical algorithms to streamline reporting and billing, to help triage data to make sense of relevant vs. not clinically relevant alerts and to decrease the amount of time spent by physicians, nurses and technicians on interpreting the data.”
A new scientific statement from the Heart Rhythm Society and other electrophysiology societies around the world recommends that remote monitoring be alert-based, as is the case with the Implicity platform, and gives a class IIa recommendation to Implicity, which has an FDA-approved artificial intelligence-based software system, as an appropriate third-party platform for optimizing resources and quality, Rosier told Healio.
Compared with those with no remote monitoring, patients with any remote monitoring had a modest 1-year survival benefit (adjusted HR = 0.96; P < 10-4). However, those with remote monitoring had more hospitalizations per year, more HF hospitalizations per year and more days in the hospital for HF per year than those without it (P for all < 10-4), according to the researchers.
Among those with remote monitoring, those with the Implicity platform had a higher 1-year survival rate than those with conventional remote monitoring (aHR = 0.78; P < 10-4), as well as fewer hospitalizations per year, fewer HF hospitalizations per year, fewer days in the hospital per year and fewer days in the hospital for HF per year (P for all < 10-4), the researchers found.
Because the study is retrospective and nonrandomized, it may have bias, Rosier told Healio. “The centers using Implicity may be different from the others, and they are probably very committed to the quality of remote monitoring,” he said.
“Not only can a universal platform make it easier to do remote monitoring, but it may actually now be standard of care,” Rosier told Healio.
In the United States, about half of patients with implanted devices do not have remote monitoring, and many centers that offer it do not submit for reimbursement despite coverage by CMS, Rosier told Healio. “At the end of the day, they are using expensive resources and struggling, but they don’t collect the money they should collect. This means they need to organize better. There is no reason to wait for this issue to be solved magically. It’s quite obvious what kinds of solutions are on the market.”
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Varma N, et al. Late Breaking Clinical Trials and Science – Registry – CIED. Presented at: Heart Rhythm 2023; May 19-21, 2023; New Orleans (hybrid meeting).
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