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Remote monitoring of implantable cardioverter defibrillators versus quarterly device interrogations in clinic: results from a randomized pilot clinical trial.

Publication ,  Journal Article
Al-Khatib, SM; Piccini, JP; Knight, D; Stewart, M; Clapp-Channing, N; Sanders, GD
Published in: J Cardiovasc Electrophysiol
May 2010

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.

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Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

May 2010

Volume

21

Issue

5

Start / End Page

545 / 550

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Telephone
  • Quality of Life
  • Pilot Projects
  • Patient Satisfaction
  • Office Visits
  • Monitoring, Physiologic
  • Middle Aged
  • Male
  • Humans
 

Citation

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Al-Khatib, S. M., Piccini, J. P., Knight, D., Stewart, M., Clapp-Channing, N., & Sanders, G. D. (2010). Remote monitoring of implantable cardioverter defibrillators versus quarterly device interrogations in clinic: results from a randomized pilot clinical trial. J Cardiovasc Electrophysiol, 21(5), 545–550. https://doi.org/10.1111/j.1540-8167.2009.01659.x
Al-Khatib, Sana M., Jonathan P. Piccini, David Knight, Margaret Stewart, Nancy Clapp-Channing, and Gillian D. Sanders. “Remote monitoring of implantable cardioverter defibrillators versus quarterly device interrogations in clinic: results from a randomized pilot clinical trial.J Cardiovasc Electrophysiol 21, no. 5 (May 2010): 545–50. https://doi.org/10.1111/j.1540-8167.2009.01659.x.
Al-Khatib SM, Piccini JP, Knight D, Stewart M, Clapp-Channing N, Sanders GD. Remote monitoring of implantable cardioverter defibrillators versus quarterly device interrogations in clinic: results from a randomized pilot clinical trial. J Cardiovasc Electrophysiol. 2010 May;21(5):545–50.
Al-Khatib, Sana M., et al. “Remote monitoring of implantable cardioverter defibrillators versus quarterly device interrogations in clinic: results from a randomized pilot clinical trial.J Cardiovasc Electrophysiol, vol. 21, no. 5, May 2010, pp. 545–50. Pubmed, doi:10.1111/j.1540-8167.2009.01659.x.
Al-Khatib SM, Piccini JP, Knight D, Stewart M, Clapp-Channing N, Sanders GD. Remote monitoring of implantable cardioverter defibrillators versus quarterly device interrogations in clinic: results from a randomized pilot clinical trial. J Cardiovasc Electrophysiol. 2010 May;21(5):545–550.
Journal cover image

Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

May 2010

Volume

21

Issue

5

Start / End Page

545 / 550

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Telephone
  • Quality of Life
  • Pilot Projects
  • Patient Satisfaction
  • Office Visits
  • Monitoring, Physiologic
  • Middle Aged
  • Male
  • Humans