Key result
Remote monitoring is linked to a ~79-day shorter AHRE evaluation delay versus conventional follow-up.
Why the study?
Remote monitoring of implantable cardiac devices enables continuous surveillance of atrial high rate episodes, but its impact on evaluation and treatment timing compared to conventional follow-up needed further evidence.
Does remote monitoring reduce the interval from atrial high rate episode onset to physician evaluation and therapy adjustment in dual-chamber pacemaker recipients?
Cohort (n=97)
Does remote monitoring reduce the interval from atrial high rate episode onset to physician evaluation and therapy adjustment in dual-chamber pacemaker recipients?
Remote monitoring in pacemaker patients significantly reduces the delay in evaluating atrial high rate episodes and prompts earlier therapy adjustment compared to conventional biannual in-office follow-up.
RM shortens AHRE evaluation and treatment delays versus conventional follow-up; leaves open whether this improves outcomes in pacemaker patients.
Aim Remote monitoring (RM) of implantable cardiac devices has enabled continuous surveillance of atrial high rate episodes (AHREs) with well‐recognized clinical benefits. We aimed to add evidence on the role of the RM as compared to conventional follow‐up by investigating the interval from AHRE onset to physician’s evaluation and reaction time in actionable episodes. Methods and Results A total of 97 dual‐chamber pacemaker recipients were followed with RM (RM‐ON group; N = 64) or conventional in‐office visits (RM‐OFF group; N = 33) for 18 months. In‐office visits were scheduled at 1, 6, 12, and 18 months in the RM‐OFF group and at 1 and 18 months in the RM‐ON group. The overall AHRE rate was 1.98 per patient‐year (95% confidence interval [CI], 1.76–2.20) with no difference between the two groups (RM‐ON vs. RM‐OFF weighted‐HR, 0.88; CI, 0.36–2.13; p = .78). In the RM‐ON group, 100% AHREs evaluated within 11 days from onset, and within 202 days in the RM‐OFF group, with a median evaluation delay 79 days shorter in the RM‐ON group versus the RM‐OFF group (p < .0001). Therapy adjustment in actionable AHREs occurred 77 days earlier in the RM‐ON group versus the control group (p < .001). In the RM‐ON group, there were 50% less in‐office visits as compared to the RM‐OFF group (p < .001). Conclusions In our pacemaker population with no history of atrial fibrillation, RM allowed significant reduction of AHRE evaluation delay and prompted treatment of actionable episodes as compared to biannual in‐office visit schedule.
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Russo et al. (2022) conducted a cohort in Atrial high rate episodes in pacemaker patients (n=97). Remote monitoring vs. Conventional in-office visits was evaluated on Interval from AHRE onset to physician's evaluation (79 days shorter, p=<.0001). Remote monitoring in pacemaker patients reduced the median evaluation delay of atrial high rate episodes by 79 days compared to conventional follow-up (p < .0001).
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