Pacemaker battery life stretched with remote monitoring, optimized pacing

It sounds contradictory, but more pacemaker monitoring could lead to longer battery life. An Italian retrospective analysis compared battery life between pacemakers with remote monitoring on vs. off and found that with remote monitoring on, patients went approximately 11 months longer between battery replacements.

The study, led by Renato Pietro Ricci, MD, from the San Filippo Neri Hospital in Rome, reviewed hospital and follow-up files on 201 non-consecutive patients implanted with a CylosDR-T dual-chamber pacemaker (Biotronik). The devices were implanted between 2006 and 2010. Remote monitoring was on in 67 percent of devices. The median follow-up was 56.4 months and the database used for follow-up closed in 2014. At that time, 55 percent of patients with remote monitoring on and 49 percent of patients with remote monitoring off still had active pacemakers.

The longevity for pacemakers with remote monitoring on was 71.1 months. For pacemakers with remote monitoring off, longevity was 60.4 months. Both were consistent with previous estimates.

Consistent with earlier studies, loss to follow-up was more frequent in those who weren’t remotely monitored than those who were (33 percent vs. 4 percent). Likewise, patients with remote monitoring had 16 percent fewer in-hospital visits.

Patients with remote monitoring had more active follow-up; device programing was changed at least once in 33.3 percent of those with remote monitoring turned on, as opposed to 25 percent of those with remote monitoring turned off. This lead to an overall lower time weighted average of ventricular pulse amplitude and pacing percentage for remotely monitored patients. Ricci et al noted that in the remote monitoring group, active ventricular capture control and automatic output adjustment algorithm was more frequent (83 percent vs. 54 percent).

They suggested that increased battery life in the devices with remote monitoring on could be explained by optimized device programing. “This result emphasizes the importance of evaluating additional device diagnostic or therapeutic features in relation to the associated energy demand and consequent effects on longevity,” Ricci et al wrote.

The study was published in the February issue of Heart Rhythm.