Decreased Delivery of Inappropriate Shocks Achieved by Remote Monitoring of ICD: A Substudy of the ECOST Trial

Abstract

RM was highly effective in the long-term prevention of inappropriate ICD shocks.

HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices

“…Even in the ECOST study, 23,46 in which the number of patients with appropriate shocks was more than twice the number of patients with inappropriate shocks, the number of patients who were administered appropriate shocks was similar in both the remote follow-up and control arms of the study (16.7% vs 17.5%; P = .84).…”

“…The ECOST study 23,46 evaluated ICD therapy events as a prespecified secondary end point and reported a significant reduction in inappropriate therapy for patients assigned to the RM arm. Over 27 months, the incidence of inappropriate shocks was 5.0% in the patients randomized to the RM group compared with 10.4% in the standard group (P = .04).…”

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

“…Therefore, that study recommended programming a higher level of energy after ATP [172]. Finally, a substudy of the Effectiveness and Cost of ICD Follow-Up Schedule with Telecardiology (ECOST) study, which randomly assigned 433 patients to remote monitoring (n ¼221; active group) vs ambulatory follow-up (n¼ 212; control group), showed that remote monitoring was highly effective in the long-term prevention of inappropriate ICD shocks through early detection and prevention of AF with a rapid ventricular rate, nonsustained VT, or diverted VT episodes [173].…”

Validation of an Organizational Management Model of Remote Implantable Cardioverter-Defibrillator Monitoring Alerts

“…[21][22][23][24] Additional personalization of the alert programming, based on the clinical profile of each patient at the time of ICD implantation, evolving with the evolution of the disease, might further optimize RM. It is noteworthy that the medical response brought about changes in patient management in 92% of instances, representing a high return.…”

“…During a mean follow-up of 16±7 and median of 17 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) months, 562 patients were enrolled. The baseline characteristics of the study population are shown in Table 1.…”