Remote monitoring of patients with implantable cardioverter-defibrillators: Perception of the impact of monitoring and selected determinants of quality of life

Abstract

The number of patients with implantable cardioverter-defibrillators (ICD) has been continuously rising. Telemonitoring care (Home Monitoring TM-HM) has been increasingly used during the monitoring of these patients. Methods: 150 patients with ICDs who were monitored using the HM system (HM+), and 150 patients with ICDs who were monitored using standard outpatient checkups (HM-) were included. A questionnaire, which focused on the quality of life (QoL) (EQ5D-3L), level of anxiety and depression (HADS), and a custom questionnaire examining the subjective approach of patients to the HM system and telecare workflow, was sent out to all patients. Results: The method of ICD monitoring did not directly influence the QoL (p = NS). A non-significant trend towards better QoL in HM+ compared to HM-patients was recorded. It was based on total QoL scores (68.6 ± 19 vs. 64.6 ± 16.5, p = 0.09). Regarding anxiety and depression, statistical testing also failed to find any difference between HM+ and HM-patients. The most striking difference between HM+ and HM-patients was recorded in the preference for the type of monitoring. 54.9% of HM-patients were interested in remote monitoring, 45.1% said they preferred outpatient checkups , and only 6.7% (p < 0.0001) of HM+ patients were interested in switching to outpatient checkups from remote monitoring. HM+ patients were more inclined to use remote ICD monitoring (p = 0.007) and had a positive approach toward the telecare system (p = 0.034). Conclusion: The method of device monitoring does not significantly affect QoL in patients with ICDs, nor does it affect levels of anxiety and depression. Generally, patients with ICDs monitored using the HM system were very satisfied with telecare and would prefer not to lose remote ICD monitoring.