Is There a Future for Remote Cardiac Implantable Electronic Device Management?

In the era of communication technology, remote monitoring has been a paradigm shift in the way patients with cardiac implantable electronic devices are managed. It has been endorsed by scientific societies and is being increasingly adopted in the clinical setting. Despite the various advantages associated with this strategy, data on improved clinical outcome are still sparse. The recently published study on the remote management of heart failure using implanted devices and formalised follow-up procedures, which turned out to be negative, has cast doubt on whether remote monitoring should still be used. This article provides a critical appraisal of the study, and discusses the issue of remote data management.

[1]  Yi Zhang,et al.  A Multisensor Algorithm Predicts Heart Failure Events in Patients With Implanted Devices: Results From the MultiSENSE Study. , 2017, JACC. Heart failure.

[2]  Gerhard Hindricks,et al.  Remote monitoring and heart failure: monitoring parameters, technology, and workflow. , 2016, European heart journal.

[3]  Haran Burri,et al.  Effects of remote monitoring on clinical outcomes and use of healthcare resources in heart failure patients with biventricular defibrillators: results of the MORE‐CARE multicentre randomized controlled trial , 2017, European journal of heart failure.

[4]  R. Mahajan,et al.  Remote Monitoring of Implantable Cardioverter-Defibrillators: A Systematic Review and Meta-Analysis of Clinical Outcomes. , 2015, Journal of the American College of Cardiology.

[5]  P. Brugada,et al.  Remote monitoring: a cost or an investment? , 2011, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[6]  J. Nielsen,et al.  ESC Guidelines on cardiac pacing and cardiac resynchronization therapy , 2014 .

[7]  G. Hindricks,et al.  Daily remote monitoring of implantable cardioverter-defibrillators: insights from the pooled patient-level data from three randomized controlled trials (IN-TIME, ECOST, TRUST) , 2017, European heart journal.

[8]  Niraj Varma,et al.  Superiority of automatic remote monitoring compared with in-person evaluation for scheduled ICD follow-up in the TRUST trial - testing execution of the recommendations , 2014, European heart journal.

[9]  Renato Pietro Ricci,et al.  HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices. , 2015, Heart rhythm.

[10]  A. Boyle,et al.  The CONNECT (Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision) trial: the value of wireless remote monitoring with automatic clinician alerts. , 2011, Journal of the American College of Cardiology.

[11]  G. Boriani,et al.  Risk stratification of cardiovascular and heart failure hospitalizations using integrated device diagnostics in patients with a cardiac resynchronization therapy defibrillator , 2018, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[12]  A. Skanes,et al.  A novel algorithm to assess risk of heart failure exacerbation using ICD diagnostics: validation from RAFT. , 2014, Heart rhythm.

[13]  Haran Burri,et al.  The MOnitoring Resynchronization dEvices and CARdiac patiEnts (MORE-CARE) Randomized Controlled Trial: Phase 1 Results on Dynamics of Early Intervention With Remote Monitoring , 2013, Journal of medical Internet research.

[14]  H. Heidbuchel,et al.  EuroEco (European Health Economic Trial on Home Monitoring in ICD Patients): a provider perspective in five European countries on costs and net financial impact of follow-up with or without remote monitoring , 2014, European heart journal.

[15]  E. Heist,et al.  Analysis of different device-based intrathoracic impedance vectors for detection of heart failure events (from the Detect Fluid Early from Intrathoracic Impedance Monitoring study). , 2014, The American journal of cardiology.

[16]  William T. Abraham,et al.  Development and validation of an integrated diagnostic algorithm derived from parameters monitored in implantable devices for identifying patients at risk for heart failure hospitalization in an ambulatory setting , 2013, European heart journal.

[17]  R. Schweikert,et al.  Automatic Remote Monitoring of Implantable Cardioverter-Defibrillator Lead and Generator Performance: The Lumos-T Safely RedUceS RouTine Office Device Follow-Up (TRUST) Trial , 2010, Circulation. Arrhythmia and electrophysiology.

[18]  R. Stadler,et al.  Reasons for Loss of Cardiac Resynchronization Therapy Pacing: Insights From 32 844 Patients , 2012, Circulation. Arrhythmia and electrophysiology.

[19]  Lluís Mont,et al.  2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). , 2013, European heart journal.

[20]  J. Morgan,et al.  Remote management of heart failure using implantable electronic devices , 2017, European heart journal.