Remote monitoring of implantable cardioverter defibrillator patients: a safe, time-saving, and cost-effective means for follow-up

• Published in: Europace (London, England) Vol. 10; no. 10; pp. 1145 - 1151
• Main Authors: Raatikainen, M.J. Pekka, Uusimaa, Paavo, van Ginneken, Mireille M.E., Janssen, Jacques P.G., Linnaluoto, Markku
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.10.2008; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Clinical Research; Cost-Benefit Analysis - economics; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - prevention & control; Defibrillators, Implantable - economics; Defibrillators, Implantable - statistics & numerical data; Female; Health Care Costs - statistics & numerical data; Humans; Internet - economics; Internet - statistics & numerical data; Male; Middle Aged; Netherlands - epidemiology; Remote Consultation - economics; Remote Consultation - statistics & numerical data; Workload - statistics & numerical data; Netherlands; Usability; Cost-effectiveness; Remote monitoring; Implantable cardioverter defibrillator
• ISSN: 1099-5129; 1532-2092; 1532-2092
• DOI: 10.1093/europace/eun203

Aims The purpose of this prospective study was to investigate whether internet-based remote monitoring offers a safe, practical, and cost-effective alternative to the in-office follow-up visits of patients with an implantable cardioverter defibrillator (ICD). Methods and results Forty-one patients (62 ± 10 years, range 41-76, 83% male) with previously implanted ICD were followed for 9 months. One-hundred and nineteen scheduled and 18 unscheduled data transmissions were performed. There were no device-related adverse events. Over 90% of the patients found the system easy to use. Physicians reported the system as being 'very easy' or 'easy' to use and found the data comparable to traditional device interrogation in 99% of the cases. They were able to address all unscheduled data transmissions remotely. Compared with the in-office visits, remote monitoring required less time from patients (6.9 ± 5.0 vs. 182 ± 148 min, P < 0.001) and physicians (8.4 ± 4.5 vs. 25.8 ± 17.0 min, P < 0.001) to complete the follow-up. Substitution of two routine in-office visits during the study by remote monitoring reduced the overall cost of routine ICD follow-up by 524€ per patient (41%). Conclusion Remote monitoring offers a safe, feasible, time-saving, and cost-effective solution to ICD follow-up.