June 30, 2026Journal of the American College of Cardiology
The CONNECT (Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision) Trial
Key result
Wireless remote monitoring cuts time to clinical decision by ~17 days versus standard in-office care.
- P<0.001
- n=1,997
Why the study?
Implantable cardioverter-defibrillator technology allows wireless remote monitoring with automatic clinician alerts to potentially replace some scheduled visits, but whether it reduces time to clinical decision-making or healthcare utilization compared to standard in-office care required evaluation.
Does wireless remote monitoring with automatic clinician alerts reduce the time from a clinical event to a clinical decision in patients with implantable cardioverter-defibrillators compared to standard in-office care?
Population
1,997 patients who underwent insertion of an implantable cardioverter-defibrillator or CRT device across 136 clinical sites
Comparison
Wireless remote monitoring with automatic clinician alerts vs standard in-office care
Design
Multicenter prospective randomized evaluation
Follow-up
15 months
Authors
Discussion
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Member takes
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The CONNECT data showed remote monitoring with the CareLink Network not only significantly reduced the time to clinical decision, but also may reduce the need for standard in-clinic visits, which may not always be necessary for the patient, and often place added burden on the physician's clinic. At the same time, these data lead us to believe there may be other potential benefits of remote monitoring, including a reduction in mean length of stay for cardiovascular hospitalizations, which may have an economic impact on the patient and the healthcare system.”
“The results from the CONNECT trial reinforce the important role of the CareLink Network in improving the overall care of patients treated with implantable cardiac devices. With better utilization of the remote monitoring system, earlier treatment intervention can ultimately result in improved clinical outcomes. We saw a correlation between improved clinical outcomes and a reduction in healthcare utilization costs, benefiting both the patient and the healthcare system.”
PMPat MackinPresident, Cardiac Rhythm Disease Management, Medtronic
“Our CareLink Network is a vital, clinically validated patient management tool that is associated with numerous benefits, as demonstrated in the CONNECT trial. We are fully committed to providing patients and physicians with superior cardiovascular management tools that help treat an array of debilitating heart rhythm conditions, as well as help remove costs from the healthcare system.”
Implication
May shorten decision times and CV stays with remote ICD monitoring; leaves open outcome confirmation in practice.
Key Points
- Determine if wireless remote monitoring reduces time from clinical events to clinical decisions compared to standard care.
- Multicenter, prospective, randomized evaluation involving 1,997 patients with implantable cardioverter-defibrillators
- Follow-up duration of 15 months and comparison of remote monitoring vs. in-office care
- Health care utilization data included all CV-related hospitalizations and visits
- Median time from clinical event to decision reduced from 22 days (in-office) to 4.6 days (remote), p < 0.001
- Mean length of stay per CV hospitalization decreased from 4.0 days (in-office) to 3.3 days (remote), p = 0.002
Study Design
Type
RCT (n=1,997)
Randomization
randomized
Multicenter
Yes
Structured PICO
Does wireless remote monitoring with automatic clinician alerts reduce the time from a clinical event to a clinical decision in patients with implantable cardioverter-defibrillators compared to standard in-office care?
P
Population
1,997 patients who underwent insertion of an implantable cardioverter-defibrillator or cardiac resynchronization therapy device, followed for 15 months.
I
Intervention
Wireless remote monitoring with automatic clinician alerts
C
Comparator
Standard in-office care and follow-up
O
Outcome
Time from a clinical event to a clinical decision in response to arrhythmias, cardiovascular disease progression, and device issues
Main Result
Absolute Event Rate: 4.6% vs 22%
p-value: p=< 0.001
Wireless remote monitoring with automatic alerts for ICD/CRT patients significantly reduces the time to clinical decision-making and decreases the length of cardiovascular hospital stays compared to standard in-office follow-up.
Cite This Study
Crossley et al. (2011) conducted an RCT in Implantable cardioverter-defibrillator insertion (n=1,997). Wireless remote monitoring with automatic clinician alerts vs. Standard in-office care was evaluated on Time from a clinical event to a clinical decision in response to arrhythmias, cardiovascular disease progression, and device issues (p=< 0.001). Wireless remote monitoring with automatic clinician alerts significantly reduced the median time from clinical event to clinical decision compared to standard in-office care (4.6 vs 22 days; p<0.001).