Remote monitoring ICDs associated with reduced mortality and re-hospitalization rates

At the outset, it’s important to note that these findings were presented in an abstract format but have yet to be published in a peer review journal. With that in mind, the researchers reported a lower 3-year mortality in patients utilizing remote monitoring that was statistically significant (HR=0.67; 95% CI, 0.64-0.7) even when controlling for factors like age, gender, ischemic vs. nonischemic disease, and more. Similarly they identified a lower risk of rehospitalization when looking at the subset of Medicare patients for whom that data was available (HR=0.81; 95% CI, 0.79-0.83).

These results are very impressive, but as iMedalApps states, there’s a few caveats that need to be considered:

1. A phone line is required. In some dense city or sparsely populated rural areas this could be a problem.
2. Not all patients may be health literate enough to be able to use the device.
3. Use of the device has an added cost.

There is also confounding factors to be considered:

There are also conceivable ways that a mortality benefit could perhaps be achieved. Perhaps, for example, the use of remote monitoring leads to a consistent reduction in inappropriate shocks or in device malfunctions that would prevent appropriate shocks. Alternatively, maybe by catching inappropriate device activity earlier, there are less iatrogenic complications or effects on the heart or maybe there is some other mechanism at play here that has yet to be identified.