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

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 patient experiences with RPM, examined patient preferences for ICD follow-up, and identified determinants of patient preferences in the first two years post-implantation.

METHODS: European heart failure patients (N = 300; median age = 66 years (IQR = 59-73), and 22% female) with a first-time ICD received a Boston Scientific LATITUDE® RPM system and had scheduled in-clinic follow-ups once a year. Patients completed questionnaires 1-2 weeks and 3, 6, 12 and 24 months post-implantation, and clinical data was obtained from their medical records. Patient evaluation data was 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 two years post-implantation, the median patient satisfaction score with the RPM system was 9/10 (IQR = 8-10), despite 53% of the patients experiencing issues (e.g. 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 = .04), employed (p = .04), and equipped with a new LATITUDE® model (p = .04), but less likely to suffer from chronic obstructive pulmonary disease (p = .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. This article is protected by copyright. All rights reserved.