Remote monitoring (RM) of Implantable Cardiac Defibrillators (ICDs) for the management of patients with heart failure (HF) is a reliable and feasible concept to prevent impending acute HF de-compensation.
The design of this study was to determine the value of monthly cardiac devices interrogations for patients with ICDs as compared to quarterly in-office interrogations and to assess the anxiety level of both groups of patients at baseline and upon completions of the study.
This was a prospective single centered pilot clinical trial where patients were randomly allocated to the conventional quarterly face-to-face encounter (control group) or to the group that had a Medtronic CareLink monitor for monthly transmissions (experimental group). Additionally, both groups completed the Beck Anxiety Inventory questionnaire at baseline and at the conclusion of the study. The primary endpoint was a composite of cardiac hospitalizations, emergency visits and unscheduled visits to the arrhythmia clinic for worsening of HF.
The results of remote device interrogations and quarterly visits were received from 34 participants between June 2013 and February 2014. There were no hospitalizations in the Quarterly group and there was one subject in the Monthly group who had three hospitalizations, but the remaining subjects in that group did not have any hospitalizations. Baseline anxiety and post-study questionnaires were completed and returned by all 34 patients.
The difference between the Post-Anxiety score and the Pre-Anxiety score was analyzed separately for each group using the paired t-test, there was a marginally non-significant difference in the Monthly interrogation group (mean difference = 2.71, corresponding 95% confidence interval = [-0.025, 5.44], (p
This small pilot study showed no significant reduction in cardiac related resource utilization with monthly RM of ICDs as compared with standard in-office quarterly follow-ups. Additional large clinical studies are needed to precisely investigate the health impact of RM in HF patients with ICDs.
Gargiulo, Jeanne, "Can Remote Monitoring Improve Quality of Care in Heart Failure Patients with Implantable Cardioverter Defibrillators?" (2014). GW Research Days 2014. Paper 3.