Why the study?
The effect of remote monitoring on atrial arrhythmia detection, stroke reduction, and anticoagulation therapy remains unknown, particularly for patients with implantable or wearable cardiac devices.
Does remote monitoring improve detection of atrial arrhythmia and reduce stroke risk in patients with implantable or wearable cardiac devices compared to in-office follow-up?
Does remote monitoring improve detection of atrial arrhythmia and reduce stroke risk in patients with implantable or wearable cardiac devices compared to in-office follow-up?
Remote monitoring is effective for detecting atrial arrhythmias in patients with wearable devices and for reducing stroke risk in patients with cardiovascular implantable electronic devices.
Supports RM integration into device care to curb stroke; confirms RCT-level efficacy for arrhythmia detection and anticoagulation guidance.
BACKGROUND: The effect of remote monitoring (RM) in atrial arrhythmia detection, stroke reduction, and anticoagulation therapy remains unknown, particularly for patients with implantable or wearable cardiac devices. METHODS AND RESULTS: We performed a systematic review and meta-analysis to evaluate the role of RM in atrial arrhythmia detection, stroke reduction and anticoagulation therapeutic intervention. Online databases were queried to include randomized controlled trials comparing detection of atrial arrhythmia and stroke risk between patients undergoing RM and those receiving in-office (IO) follow-up. Outcomes and complications of RM-guided anticoagulation therapy and conventional therapy in patients with atrial fibrillation were also reviewed. A total of 16 studies were included. Compared with patients receiving IO follow-up, patients undergoing RM had a significantly higher detection rate of atrial arrhythmia (risk ratio [RR], 1.363; 95% confidence interval [CI], 1.147-1.619), and a lower risk of stroke (RR, 0.539; 95% CI, 0.301-0.936). The higher rate of atrial arrhythmia was only noted in patients with wearable devices (RR, 4.070; 95% CI, 2.408-6.877), and the lower risk of stroke was only noted in patients with cardiovascular implantable electronic devices (CIED) (RR, 0.513; 95% CI, 0.265-0.996). CONCLUSIONS: RM is effective for atrial arrhythmia detection in patients using wearable devices and for reducing the risk of stroke in patients with CIED.
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Jang et al. (2020) studied this question.
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