Key result
Substituting an in-person annual visit with remote monitoring for ICD patients yielded similar clinical event rates compared to scheduled remote monitoring (11.5% vs 7.6%; P=0.25).
Why the study?
The COVID-19 pandemic disrupted in-person follow-up visits for cardiac implantable electronic devices, highlighting the need to evaluate remote monitoring of ICDs when substituting for in-person visits.
Does substituting an in-person annual visit with a remote monitoring session affect the identification of clinical events or need for physician intervention in patients with ICDs during the COVID-19 pandemic?
Cross-Sectional (n=329)
Does substituting an in-person annual visit with a remote monitoring session affect the identification of clinical events or need for physician intervention in patients with ICDs during the COVID-19 pandemic?
Absolute Event Rate: 11.5% vs 7.6%
p-value: p=.25
Remote monitoring of ICDs is an effective alternative to in-person annual visits during the COVID-19 pandemic, adequately identifying clinical events regardless of the time since the last in-person visit.
Should not yet replace annual in-person ICD visits; leaves open long-term safety of remote-only follow-up at longer intervals.
BACKGROUND: Monitoring of cardiac implantable electronic devices was highly impacted by the COVID-19 pandemic considering the high volume of in-person visits for regular follow-up. Recent recommendations highlight the important role of remote monitoring to prevent exposure to the virus. This study compared remote monitoring of implantable cardioverter defibrillators (ICDs) in patients whose in-person annual visit was substituted for a remote monitoring session with patients who were already scheduled for a remote monitoring session. METHODS: This was a cross-sectional observational study of 329 consecutive patients between 20 March and 24 April 2020. Group 1 included 131 patients whose in-person annual visit was substituted for a remote monitoring session. Group 2 included 198 patients who underwent a remote monitoring session as scheduled in their usual device follow-up. The time interval since the last in-person visit was 13.3 ± 3.2 months in group 1 and 5.9 ± 1.7 months in group 2 (P < .01). RESULTS: In group 1, 15 patients (11.5%) experienced a clinical event compared to 15 patients (7.6%) in group 2 (P = .25). Nineteen patients (14.5%) required a physician intervention in group 1 compared to 19 patients (9.6%) in group 2 (P = .22). Two patients (1.5%) in group 1 and four patients (2.0%) in group 2 required an early in-person follow-up visit during the pandemic (P > .99). CONCLUSION: Remote monitoring of ICDs is useful to identify clinical events and allows physicians to treat patients appropriately during the COVID-19 pandemic regardless of the time interval since their last in-person visit. It reduces significantly in-person visit for regular follow-up.
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Larochellière et al. (2020) conducted a cross-sectional in Patients with implantable cardioverter defibrillators (ICDs) (n=329). In-person annual visit substituted for a remote monitoring session vs. Remote monitoring session as scheduled in usual device follow-up was evaluated on Clinical event (p=.25). Substituting an in-person annual visit with remote monitoring for ICD patients yielded similar clinical event rates compared to scheduled remote monitoring (11.5% vs 7.6%; P=0.25).
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