Feasibility and Safety of Medium-Term Remote-Only Monitoring in a Large Cohort of Biotronik Pacemaker Patients

Remote monitoring (RM) enables convenient follow-up of patients with cardiac implantable electronic devices. In remote-only monitoring (RM-only), in-person visits are only scheduled if needed based on RM findings. This study evaluated the feasibility and safety of medium-term RM-only of pacemaker (PM) patients.

All patients with Biotronik PM were included in the analysis. Data on the number and causes of additional in-office device interrogations, actions due to the transmissions, hospitalizations and performance of RM were collected from a large cohort of PM patients followed by RM-only.

In total, 606 patients (302 females) with a mean age of 78 ± 12 years were included in the analysis. During the mean follow-up of 2.8 years, 445 additional in-office device interrogations were made in 287 patients (0.3 interrogations/year), and in 110 (25%) of these cases, changes to device programming were made. In a subgroup analysis of 100 patients with at least one year of prior appointment-based device monitoring, the need for in-office visits was 6.9 times higher per follow-up year than in RM (IRR = 6.9, 95% CI 4.9-9.9; p < 0.001). The hospitalization rate in the entire cohort during RM was 0.3 / year with no difference in the rate of hospitalizations between the two monitoring methods (IRR 1, 95% CI 0.8-1.4, p = 0.8). The success of daily transmissions was 91.7%.

Our real-world data indicate that RM-only may be a viable option for long-term follow-up of PM patients. Portions of this manuscript contain text overlap with our previously published work because they describe the same methodology and standard clinical procedures. All overlapping material has been appropriately cited, and no previously published data, results, or conclusions have been duplicated without attribution.