ICD remote monitoring: A validated organizational model of transmission management

Abstract

Background Implantable cardioverter-defibrillators (ICD) are a standard therapy to prevent sudden cardiac death (SCD). Remote monitoring (RM) of ICD patients provides healthcare quality improvement and resource savings compared with standard in-hospital visits. Only limited data exist about RM organizations. Objectives We aimed to evaluate and validate our institutional optimized RM organization model for ICD patients. Methods This observational study compared two RM models with an iterative qualitative and quantitative approach in 562 ICD patients: RM1 with device diagnostics evaluation by nurses and cardiologists, and RM2 with a selected approach with decision trees for actions. The main endpoints were in-hospital professional actions and times related to RM alerts. Results During RM1, 1134 alerts occurred in 427 patients (286 patient-years) of which 376 (33%) were submitted to cardiologist review whereas during RM2, 1522 alerts occurred in 562 patients (458 patient-years) of which 273 (18%) were submitted to cardiologist review (P Conclusion In ICD patients, optimized RM strategy based on automatic alerts and decision trees allows to focus on clinically relevant events and to reduce healthcare resources without compromising quality.