A comparative effectiveness study of more than 250,000 patients implanted with cardiac devices between 2008 and 2011 found that embedding remote monitoring technology led to improved survival.
Niraj Varma, MD, PhD, of the Cleveland Clinic, and colleagues published their findings online in the Journal of the American College of Cardiology on May 13.
They examined patients who received implantable cardioverter-defibrillators (ICDs) or cardiac resynchronization therapy with defibrillation capability (CRT-D) between October 2008 and December 2011 as well as those who received pacemakers or cardiac resynchronization therapy with pacing (CRT-P) capability between October 2009 and 2011. They obtained data from device implant registrations, device remote monitoring, postal code sociodemographic data and the U.S. Social Security Death Master File.
The study included 269,471 patients who were followed for a mean of 2.9 years. The mean age was 71, and 64.8 percent of patients were male.
The most common devices were implanted pacemakers (43 percent of patients), ICDs (32 percent), CRT-Ds (23 percent) and CRT-Ps (3 percent).
Of the patients with automatic remote monitoring devices, 53 percent never used the feature. Of the remaining patients who did use the remote monitoring capabilities, 53 percent used the remote monitoring at least 75 percent of the time they had the devices.
Significantly more patients who used the remote monitoring capabilities survived compared with those who did not take advantage of the capabilities. In addition, survival was significantly better in patients who used the monitoring at least 75 percent of the time compared with those who used monitoring less than that.
A person’s age and sex did not affect remote monitoring use. However, patients who had a landline phone or cell phone at home and those who completed at least four years were more likely to use the remote monitoring capabilities.
Meanwhile, researchers said that patients who lived below the poverty line, lacked health insurance, were unemployed, had a low income and lived in an urban neighborhood were less likely to use the remote monitoring.
“Although our observational study cannot determine a cause-and-effect relationship, the restriction of our analysis to only patients receiving wireless (remote monitoring), the correlation with survival to the degree of use, and similar gains irrespective of device type among patients with differing gravity of underlying disease provide strong indirect evidence of an independent influence of (remote monitoring) on patient outcome,” Varma et al wrote.