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Improved survival in patients enrolled promptly into remote monitoring following cardiac implantable electronic device implantation.

Publication ,  Journal Article
Mittal, S; Piccini, JP; Snell, J; Prillinger, JB; Dalal, N; Varma, N
Published in: J Interv Card Electrophysiol
August 2016

PURPOSE: Guidelines advocate remote monitoring (RM) in patients with a cardiac implantable electronic device (CIED). However, it is not known when RM should be initiated. We hypothesized that prompt initiation of RM (within 91 days of implant) is associated with improved survival compared to delayed initiation. METHODS: This retrospective, national, observational cohort study evaluated patients receiving new implants of market-released St. Jude Medical™ pacemakers (PM), implantable cardioverter defibrillators (ICD), and cardiac resynchronization therapy (CRT) devices. Patients were assigned to one of two groups: an "RM Prompt" group, in which RM was initiated within 91 days of implant; and an "RM Delayed" group, in which RM was initiated >91 days but ≤365 days of implant. The primary endpoint was all-cause mortality. RESULTS: The cohort included 106,027 patients followed for a mean of 2.6 ± 0.9 years. Overall, 47,014 (44 %) patients had a PM, 31,889 (30 %) patients had an ICD, 24,005 (23 %) patients had a CRT-D, and 3119 (3 %) patients had a CRT-P. Remote monitoring was initiated promptly (median 4 weeks [IQR 2, 8 weeks]) in 66,070 (62 %) patients; in the other 39,957 (38 %) patients, RM initiation was delayed (median 24 weeks [IQR 18, 34 weeks]). In comparison to delayed initiation, prompt initiation of RM was associated with a lower mortality rate (4023 vs. 4679 per 100,000 patient-years, p < 0.001) and greater adjusted survival (HR 1.18 [95 % CI 1.13-1.22], p < 0.001). CONCLUSIONS: Our data, for the first time, show improved survival in patients enrolled promptly into RM following CIED implantation. This advantage was observed across all CIED device types.

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Published In

J Interv Card Electrophysiol

DOI

EISSN

1572-8595

Publication Date

August 2016

Volume

46

Issue

2

Start / End Page

129 / 136

Location

Netherlands

Related Subject Headings

  • Waiting Lists
  • United States
  • Treatment Outcome
  • Time-to-Treatment
  • Telemedicine
  • Survival Rate
  • Risk Factors
  • Retrospective Studies
  • Remote Sensing Technology
  • Prevalence
 

Citation

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Mittal, S., Piccini, J. P., Snell, J., Prillinger, J. B., Dalal, N., & Varma, N. (2016). Improved survival in patients enrolled promptly into remote monitoring following cardiac implantable electronic device implantation. J Interv Card Electrophysiol, 46(2), 129–136. https://doi.org/10.1007/s10840-016-0112-y
Mittal, Suneet, Jonathan P. Piccini, Jeff Snell, Julie B. Prillinger, Nirav Dalal, and Niraj Varma. “Improved survival in patients enrolled promptly into remote monitoring following cardiac implantable electronic device implantation.J Interv Card Electrophysiol 46, no. 2 (August 2016): 129–36. https://doi.org/10.1007/s10840-016-0112-y.
Mittal S, Piccini JP, Snell J, Prillinger JB, Dalal N, Varma N. Improved survival in patients enrolled promptly into remote monitoring following cardiac implantable electronic device implantation. J Interv Card Electrophysiol. 2016 Aug;46(2):129–36.
Mittal, Suneet, et al. “Improved survival in patients enrolled promptly into remote monitoring following cardiac implantable electronic device implantation.J Interv Card Electrophysiol, vol. 46, no. 2, Aug. 2016, pp. 129–36. Pubmed, doi:10.1007/s10840-016-0112-y.
Mittal S, Piccini JP, Snell J, Prillinger JB, Dalal N, Varma N. Improved survival in patients enrolled promptly into remote monitoring following cardiac implantable electronic device implantation. J Interv Card Electrophysiol. 2016 Aug;46(2):129–136.
Journal cover image

Published In

J Interv Card Electrophysiol

DOI

EISSN

1572-8595

Publication Date

August 2016

Volume

46

Issue

2

Start / End Page

129 / 136

Location

Netherlands

Related Subject Headings

  • Waiting Lists
  • United States
  • Treatment Outcome
  • Time-to-Treatment
  • Telemedicine
  • Survival Rate
  • Risk Factors
  • Retrospective Studies
  • Remote Sensing Technology
  • Prevalence