Clinical Outcomes on Remote Monitoring Compliance in Patients With Implantable Cardioverter Defibrillator

Area of Science:

• Cardiology
• Biomedical Engineering
• Health Outcomes Research

Background:

• Remote monitoring (RM) is vital for managing patients with cardiac implantable electronic devices (CIED).
• Previous research suggests RM improves clinical outcomes.
• The impact of RM compliance on long-term patient outcomes requires further investigation.

Purpose of the Study:

• To investigate the association between compliance with remote monitoring (RM) and long-term clinical outcomes in patients with cardiac implantable electronic devices (CIED).
• To determine if adherence to RM protocols affects mortality and heart failure hospitalization rates.

Main Methods:

• Prospective single-center cohort study of 207 patients with CIEDs (implantable cardioverter-defibrillators or cardiac resynchronization therapy defibrillators) from 2018 to 2024.
• Patients stratified into compliant (≥2 scheduled transmissions/year) and non-compliant groups.
• Primary outcomes: combined all-cause mortality or heart failure hospitalization; analyzed using Kaplan-Meier and multivariable accelerated failure time models.

Main Results:

• 58 patients (28.1%) were compliant, and 149 (71.9%) were non-compliant.
• Compliant patients showed trends towards lower all-cause mortality (6.9% vs 15.4%) and heart failure hospitalizations (4% vs 12.2%).
• Multivariable analysis revealed significantly longer time to mortality or heart failure hospitalization for compliant patients (acceleration factor 0.24, p=0.022).

Conclusions:

• Compliance with remote monitoring (RM) is associated with significantly reduced combined endpoints of all-cause mortality and heart failure hospitalizations in CIED patients.
• While individual outcomes did not reach statistical significance, the overall trend favors adherence to RM.
• These findings underscore the importance of patient engagement in RM for optimizing long-term cardiovascular health management.