Patient experience and hospital workload associated with insertable cardiac monitor management: italian multicenter evaluation

Background The use of smartphone applications for remote monitoring of cardiac implantable devices, as Insertable Cardiac Monitor (ICMs), has become common standard of care in recent years. However, technology access and acceptance can still be challenging for some patients. Purpose To evaluate patient acceptance, usability, and the level of hospital support required for remote monitoring of ICMs using the myLUX Patient App, in a real-world multicenter cohort. Methods The LUX-Dx ICM is supported by the myLUX Patient App, which is designed to activate the implanted device and transmit data to the LATITUDE Clarity server for remote monitoring. A questionnaire evaluating the use and acceptance of the myLUX Patient App was administered to operators and patients across 22 Italian centers. In addition, all patients completed the Hospital Anxiety and Depression Scale (HADS) to assess psychological impact following ICM implantation. Results A total of 354 patients were included in the analysis. The majority were male (53%), aged ≥50 years (77%) and held a high school or a university degree (55%). Syncope (50%) and palpitations (15%) were the most frequent indications for ICM implantation. In 31% of cases, patients reported having a caregiver for health-related support; overall, 85% were able to manage the ICM monitoring system independently. The mean time required by the center operator to activate and connect the ICM was 7 ± 4 minutes, while the time needed to train patients on App usage was 6 ± 4 minutes. Overall, 5% of patients experienced some issues during App activation or device connection, resulting in slight delays in the activation process. During a median follow-up of 6 months [4 – 11], 59% of patients reported to check the monitoring system only in case of notification, while 33% once a day. 24% of patients received notifications of connection loss: 9% resolved the issue independently, 5% required manufacturer technical support and 10% required hospital support. The ease of use of the App was judged excellent or good by > 90% of users with no differences according to age or educational level (Figure 1). Overall, the App was well accepted and 85% of patients reported feeling reassured by being continuously monitored. The median HADS score was very low, 4 [1–7] for anxiety, and 2 [0–2] for depression. There were no differences in anxiety and depression levels according to age, sex or education level. Conclusion The Patient App for remote ICM monitoring was well accepted by patients, with minimal technical and connection issues at implantation and during follow-up. Activation time at implantation was short. The App was judged easy to use by more than 90% of patients, regardless of age or educational level, further confirming its accessibility across different patient groups.