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A prospective comparison of remote monitoring systems in implantable cardiac defibrillators: potential effects of frequency of transmissions

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Abstract

Purpose

Currently, cardiac implantable electronic devices allow remote monitoring (RM) based on periodic (Boston Latitude [LAT], Medtronic Carelink [MCL], St. Jude Merlin [SJM]) or daily transmissions (Biotronik Home Monitoring [BHM]). The aim of this study was to compare all the current RM systems in normal practice and investigate the effect of periodicity of RM transmissions on early detection of clinical and device-related events.

Methods

Two hundred eleven ICD patients (mean age 69 ± 11 years, 158 males), were remotely followed up for 1 year (61 with BHM, 49 with LAT, 65 with MCL, 36 with SJM). Remote follow-ups were configured quarterly, except for the BHM (daily transmissions).

Results

The event-free rates were 49 % with BHM, 57 % with LAT, 57 % with MCL, and 58 % with SJM (long-rank, p = 0.23). BHM generated 304 (interquartile range, 184–342) transmissions per patient in a year, LAT 9 (8–11), MCL 7 (5–10), and SJM 8 (7–14) (p < 0.000001). Eighty actionable events occurred at 1 year follow-up, 69 (86 %) with RM systems: BHM was associated with a higher cumulative rate of actionable events. At a multivariate analysis, daily transmissions were independently associated with an increased probability of event detection as compared to periodic transmission systems. The chance of event detection is reduced by 20 % (p = 0.036) for a 1-month increase of the between-transmission interval (27 % for actionable events, p = 0.004).

Conclusions

Although all RM systems effectively detected major events, daily transmission was associated with a higher probability of early event detection.

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Abbreviations

BHM:

BIOTRONIK Home Monitoring

GSM:

Global System for Mobile Communications

LAT:

Boston Latitude

MCL:

Medtronic Carelink

RM:

Remote monitoring

SJM:

St. Jude Merlin

USB:

Universal serial bus

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Acknowledgments

The authors would like to thank A.G. for statistical support and X.A. for her kind assistance in text review.

Author contributions

Ermenegildo de Ruvo, MD, and Leonardo Calò, MD, conceived and designed the study protocol, performed the analysis and interpretation of data, and participated in the preparation of the manuscript. Marco Rebecchi, MD, Federica Stirpe, CCP, Renzo Venanzio Iulianella, MD, Francesco Sebastiani, MD, Luigi Sciarra, MD, Alessandro Faganini, MD, Alessio Borrelli, MD, Domenico Grieco, MD, and Antonio Scarà, MD, performed the analysis and interpretation of data and participated in the preparation of the manuscript.

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Authors and Affiliations

  1. Division of Cardiology, ASL Roma B, Policlinico Casilino, Via della Pedica 66 W—Grottaferrata, 00046, Rome, Italy

    Ermenegildo de Ruvo, Luigi Sciarra, Anna Maria Martino, Marco Rebecchi, Renzo Venanzio Iulianella, Francesco Sebastiani, Alessandro Fagagnini, Alessio Borrelli, Antonio Scarà, Domenico Grieco, Claudia Tota, Federica Stirpe & Leonardo Calò

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  1. Ermenegildo de Ruvo
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Correspondence to Ermenegildo de Ruvo.

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de Ruvo, E., Sciarra, L., Martino, A.M. et al. A prospective comparison of remote monitoring systems in implantable cardiac defibrillators: potential effects of frequency of transmissions. J Interv Card Electrophysiol 45, 81–90 (2016). https://doi.org/10.1007/s10840-015-0067-4

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  • DOI: https://doi.org/10.1007/s10840-015-0067-4

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