Smartphone App-Based Remote Monitoring Challenges in Patients with Cardiac Resynchronization Therapy Defibrillators-A...

Area of Science:

• Cardiology
• Digital Health
• Medical Devices

Background:

• Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) improves adult patient outcomes.
• Traditional bedside transmitters have suboptimal patient adherence.
• Smartphone app-based RM offers a potential solution for enhanced patient monitoring.

Purpose of the Study:

• To evaluate the efficacy of app-based remote monitoring (abRM) in adult heart failure (HF) patients with cardiac resynchronization therapy defibrillators (CRT-D).
• To assess connectivity, adherence to scheduled follow-ups, and alert-based event prevalence with abRM.
• To compare abRM with standard care (control group).

Main Methods:

• A study population of adult HF patients with CRT-D was divided into two groups: app-based RM (abRM) and control.
• Patients in the abRM group used smartphone app solutions for remote monitoring.
• Follow-up duration was a median of 12 months, analyzing transmission success, continuous monitoring, and alert notification times.

Main Results:

• High initial transmission success (98.0%) and continuous monitoring (80.4%) were observed in the abRM group.
• Alert-based events, primarily arrhythmic and device-related, had significantly shorter notification times in the abRM group (1 day vs. 101 days; p < 0.0001).
• Patient enrollment faced challenges due to limited smartphone accessibility in the study population.

Conclusions:

• App-based RM demonstrates high compliance for initial transmissions and adherence to remote follow-ups.
• abRM provides accurate and timely event notifications, including patient-initiated emergency transmissions.
• Smartphone accessibility is a critical factor for successful implementation of app-based remote monitoring solutions.