Remote monitoring of implantable devices: Should we continue to ignore it?

Bertini, Matteo; Marcantoni, Lina; Toselli, Tiziano; Ferrari, Roberto

doi:10.1016/j.ijcard.2015.09.033

Cited by 27 publications

(16 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…for their ability to slow progression of symptomatic HF. 6 Review articles' findings have been mixed; in general, there is support for the concept of remote monitoring with differences in reported effectiveness of specific programs and technologies. [7][8][9] Telemonitoring was not shown to reduce readmission rates significantly in 2 recent large studies.…”

Section: Remote Monitoring Technologies Have Come Under Considerationmentioning

confidence: 99%

See 1 more Smart Citation

Cost‐Effectiveness of Remote Cardiac Monitoring With theCardioMEMSHeart Failure System

Schmier

Ong

Fonarow

2017

Clinical Cardiology

View full text Add to dashboard Cite

Heart failure (HF) is a leading cause of cardiovascular mortality in the United States and presents a substantial economic burden. A recently approved implantable wireless pulmonary artery pressure remote monitor, the CardioMEMS HF System, has been shown to be effective in reducing hospitalizations among New York Heart Association (NYHA) class III HF patients. The objective of this study was to estimate the cost‐effectiveness of this remote monitoring technology compared to standard of care treatment for HF. A Markov cohort model relying on the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) clinical trial for mortality and hospitalization data, published sources for cost data, and a mix of CHAMPION data and published sources for utility data, was developed. The model compares outcomes over 5 years for implanted vs standard of care patients, allowing patients to accrue costs and utilities while they remain alive. Sensitivity analyses explored uncertainty in input parameters. The CardioMEMS HF System was found to be cost‐effective, with an incremental cost‐effectiveness ratio of $44,832 per quality‐adjusted life year (QALY). Sensitivity analysis found the model was sensitive to the device cost and to whether mortality benefits were sustained, although there were no scenarios in which the cost/QALY exceeded $100,000. Compared with standard of care, the CardioMEMS HF System was cost‐effective when leveraging trial data to populate the model.

show abstract

Section: Remote Monitoring Technologies Have Come Under Considerationmentioning

confidence: 99%

“…Remote monitoring technologies have come under consideration for their ability to slow progression of symptomatic HF . Review articles’ findings have been mixed; in general, there is support for the concept of remote monitoring with differences in reported effectiveness of specific programs and technologies .…”

Section: Introductionmentioning

confidence: 99%

Cost‐Effectiveness of Remote Cardiac Monitoring With theCardioMEMSHeart Failure System

Schmier

Ong

Fonarow

2017

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…Remote monitoring (RM) of implanted devices has been shown to have a number of advantages over exclusive in-clinic follow-up [ 4 ]. Firstly, it facilitates assessment of treatment regimens and optimisation of device functionality without the need for regular outpatient visits [ 4 – 6 ]. This reduces healthcare costs, issues surrounding appointment scheduling, and transportation costs for patients living in remote areas [ 7 ], and has been suggested to result in better adherence to follow-up [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, RM can provide invaluable data for the early identification of clinically important irregularities, such as low battery output, device/lead faults, arrhythmias, and atrial fibrillation [ 11 – 14 ]. This has been demonstrated not only to allow timely prevention of clinical emergencies and mortality, but also to reduce the incidence of inappropriate device interventions [ 4 , 6 , 14 – 21 ]. Thus, the frequency of cardiovascular hospitalisation and long-term healthcare resource expenditure may be reduced [ 20 , 22 – 24 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

INvestigation on Routine Follow-up in CONgestive HearT FAilure Patients with Remotely Monitored Implanted Cardioverter Defibrillators SysTems (InContact)

Hansen

Loges

Seidl

et al. 2018

BMC Cardiovasc Disord

View full text Add to dashboard Cite

BackgroundIn heart failure (HF) patients with implantable cardioverter defibrillators (ICD) or cardiac resynchronisation therapy defibrillators (CRT-D), remote monitoring has been shown to result in at least non-inferior outcomes relative to in-clinic visits. We aimed to provide further evidence for this effect, and to assess whether adding telephone follow-ups to remote follow-ups influenced outcomes.MethodsInContact was a prospective, randomised, multicentre study. Subjects receiving quarterly automated follow-up only (telemetry group) were compared to those receiving personal physician contact. Personal contact patients were further divided into those receiving automated follow-up plus a telephone call (remote+phone subgroup) or in-clinic visits only.ResultsTwo hundred and ten patients underwent randomisation (telemetry n = 102; personal contact n = 108 [remote+phone: n = 53; visit: n = 55]). Baseline characteristics were comparable between groups and subgroups. Over 12 months, 34.8% of patients experienced deterioration of their Packer Clinical Composite Response, with no significant difference between the telemetry group and personal care (p > 0.999), remote+phone (p = 0.937) or visit (p = 0.940) patients; predefined non-inferiority criteria were met. Mortality rates (5.2% overall) were comparable between groups and subgroups (p = 0.832/p = 0.645), as were HF-hospitalisation rates (11.0% overall; p = 0.605/p = 0.851). The proportion of patients requiring ≥1 unscheduled follow-up was nominally higher in telemetry and remote+phone groups (42.2 and 45.3%) compared to the visit group (29.1%). Overall, ≥ 1 ICD therapy was delivered to 15.2% of patients.ConclusionIn HF patients with ICDs/CRT-Ds, quarterly remote follow-up only over 12 months was non-inferior to regular personal contact. Addition of quarterly telephone follow-ups to remote monitoring does not appear to offer any clinical advantage.Trial registrationclinicaltrials.gov: NCT01200381 (retrospectively registered on September 13th 2010).

show abstract

Fog Computing Architectures and Frameworks for Healthcare 4.0

Nair

Tanwar

2020

Signals and Communication Technology

View full text Add to dashboard Cite

Remote monitoring of implantable devices: Should we continue to ignore it?

Cited by 27 publications

References 61 publications

Cost‐Effectiveness of Remote Cardiac Monitoring With theCardioMEMSHeart Failure System

Cost‐Effectiveness of Remote Cardiac Monitoring With theCardioMEMSHeart Failure System

INvestigation on Routine Follow-up in CONgestive HearT FAilure Patients with Remotely Monitored Implanted Cardioverter Defibrillators SysTems (InContact)

Fog Computing Architectures and Frameworks for Healthcare 4.0

Contact Info

Product

Resources

About