Incidence and predictors of pacemaker reprogramming: potential consequences for remote follow-up

Area of Science:

• Cardiology
• Medical Device Technology
• Health Services Research

Background:

• Remote follow-up (FU) is crucial for managing the increasing number of pacemaker (PM) patients.
• While remote FU offers monitoring, it lacks device reprogramming capabilities, limiting its application.

Purpose of the Study:

• To determine the incidence of pacemaker reprogramming in bradycardia patients during long-term FU.
• To identify predictors of pacemaker reprogramming to assess the potential for remote FU.

Main Methods:

• Analysis of in-office FU data from 1517 bradycardia PM recipients in the FOLLOWPACE study (2003-2010).
• Utilized multivariable binary logistic regression to identify predictors of frequent reprogramming (>3 visits-with-reprogramming over 3 years).

Main Results:

• Only 24.5% of FU visits involved reprogramming (VWRs), affecting 79% of patients over time.
• Fifty percent of patients were reprogramming-free at 9 months, and 29% at 24 months.
• Predictors for frequent reprogramming included age, atrial arrhythmias, early PM complications, heart failure, PM indication, and lead fixation method.

Conclusions:

• A low proportion of patients require frequent pacemaker reprogramming, supporting the use of remote FU.
• Predicting patients at high risk for reprogramming remains difficult.
• Remote FU can potentially decrease unnecessary in-office visits for pacemaker management.