176-39: Remote monitoring replaces hospitalization for permanent pacemaker implantation

Abstract

Purpose: Remote monitoring are routinely used for follow-up of patients with implantable cardioverter defibrillators and cardiac resynchronization therapy devices. Patients eligible for conventional permanent pacemaker are often hospitalized for two days. There is a trend to reduce hospital overnight stays and reorganize procedures to an out patient setting. We hypothesized that remote monitoring in an outpatient setup can replace hospitalization in patients eligible for permanent pacemaker. Methods: Sixty-two consecutive patients receiving a permanent pacemaker because of sick sinus syndrome or mild AV-block were included. Patients were received in the outpatient clinic in the morning. After a successful pacemaker implantation patients were send home with a remote monitoring system. The remote systems were forced to deliver all relevant technical measurements the following morning. The primary endpoint was a successful remote follow-up within 24 hours after pacemaker implantation. The patient was contacted by phone when the measurements were received in the clinic the next day. In case of incomplete or missing data trouble shooting was done by phone. Results: In total 62 patients were included. Baseline data and follow-up results are shown in figure. No complications related to the implantation were observed. Successful follow-up were done in 60% of patients. Challenges remained in 40% of patients because of lack of transmission, missing threshold or missing EGM often solved by simple trouble shooting. Patients reported high satisfaction with the remote setup to replace hospitalization. Conclusions: Implantation of permanent pacemakers in an outpatient setting with subsequent remote monitoring is a safe alternative to conventional in-hospital implantation. However, some challenges exist in receiving immediate (< 24 h), complete transmissions.