Remote monitoring of implantable cardioverter defibrillators: Patient experiences and preferences for follow‐up

Ivy Timmermans, Mathias Meine, Istvan Szendey, Johannes Aring, Javier Romero Roldán, Lieselotte Erven, Philipp Kahlert, Edgar Zitron, Philippe Mabo, Johan Denollet, Henneke Versteeg*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
Patient satisfaction with remote patient monitoring (RPM) of implantable cardioverter defibrillators (ICDs) seems to be high, yet knowledge on long‐term patient experiences is limited. The European REMOTE‐CIED study explored patients' experiences with RPM, examined patient's preferences for ICD follow‐up, and identified determinants of patient's preferences in the first 2 years postimplantation.

Methods
European heart failure patients (N = 300; median age = 66 years [interquartile range (IQR) = 59‐73], and 22% female) with a first‐time ICD received a Boston Scientific LATITUDE RPM system (Marlborough, MA, USA) and had scheduled in‐clinic follow‐ups once a year. Patients completed questionnaires at 1‐2 weeks and also at 3, 6, 12, and 24 months postimplantation and clinical data were obtained from their medical records. Patient evaluation data were analyzed descriptively, and Student's t‐tests/Man‐Whitney U tests or Chi‐square tests/Fisher's exact tests were performed to examine determinants of patient preferences.

Results
At 2 years postimplantation, the median patient satisfaction score with the RPM system was 9 out of 10 (IQR = 8‐10), despite 53% of the patients experiencing issues (eg, failure to transmit data). Of the 221 patients who reported their follow‐up preferences, 43% preferred RPM and 19% preferred in‐clinic follow‐up. Patients with a preference for RPM were more likely to be higher educated (P = 0.04), employed (P = 0.04), and equipped with a new LATITUDE model (P = 0.04), but less likely to suffer from chronic obstructive pulmonary disease (P = 0.009).

Conclusion
In general, patients were highly satisfied with RPM, but a subgroup preferred in‐clinic follow‐up. Therefore, physicians should include patients’ concerns and preferences in the decision‐making process, to tailor device follow‐up to individual patients’ needs and preferences.
Original languageEnglish
Pages (from-to)120-129
JournalPACE. Pacing and Clinical Electrophysiology
Volume42
Issue number2
DOIs
Publication statusPublished - 2019

Keywords

  • Aged
  • Defibrillators, Implantable
  • Female
  • Follow-Up Studies
  • Heart Failure/therapy
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic/methods
  • Patient Preference
  • Patient Satisfaction
  • Self Report
  • Surveys and Questionnaires
  • Telemedicine
  • METAANALYSIS
  • ELECTRONIC DEVICES
  • ACCEPTANCE
  • patient experiences
  • remote patient monitoring
  • PERSPECTIVE
  • IMPLEMENTATION
  • INTERROGATION
  • ICD
  • PERCEPTION
  • SATISFACTION
  • implantable cardioverter defibrillator
  • patient preferences
  • EXPERT CONSENSUS

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