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Clinical Evidence

There are many published articles from well-respected peer-reviewed scientific journals that provide evidence supporting remote monitoring.

In fact according to the latest Heart Rhythm Society Remote Monitoring Consensus Statement, remote monitoring was rated as a Class I recommendation.

Some of the many clinical benefits of remote monitoring include:

  • Improve patient satisfaction
  • Improved quality of life
  • Optimised device longevity
  • Reduction in risk of inappropriate ICD shocks
  • Optimised management of atrial fibrillation and heart failure
  • Early detection of device and hardware issues

Please see the following links for further scientific evidence:

1. David Slotwiner et al. HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices. Heart Rhythm. 2015;12:e69-e100.


a. Remote monitoring labelled Class I indication and the suggested standard method of follow up

2. George H. Crossley et al. Clinical Benefits of Remote Versus Transtelephonic Monitoring of Implanted Pacemakers (PREFER). J Am Coll Cardiol 2009;54:2012-9.


a. Mean time to first diagnosis of clinical actionable events was shorter in the Remote monitoring arm

3. Mabo P, et al. COMPAS Trial Investigators. A randomized trial of long-term remote monitoring of pacemaker recipients (the COMPAS trial). Eur Heart J. 2012;33:1105-1111.


a. Remote monitoring enabled earlier detection of clinical and device-related adverse events

b. Remote monitoring was safe and reduced the number of in-office visits

4. Varma N et al. TRUST Investigators. Superiority of automatic remote monitoring compared with in-person evaluation for scheduled ICD follow-up in the TRUST trial -- testing execution of the recommendations. Eur Heart J. 2014;35:1345-1352.


a. Remote monitoring was safe in supplanting "routine" in-office visits, enabling early event detection in ICD recipients

5. Crossley G et al. The CONNECT (Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision) trial: the value of wireless remote monitoring with automatic clinician alerts. J Am Coll Cardiol. 2011;57:1181-1189.


a. Remote monitoring reduced the mean length of hospital stay

b. Remote monitoring reduced the time to a clinical decision

6. Guedon-Moreau L et al. A randomized study of remote follow-up of implantable cardioverter defibrillators: safety and efficacy report of the ECOST trial. Eur Heart J. 2012;34:605-614.


a. Remote monitoring reduces appropriate and inappropriate shocks

b. Remote monitoring was as safe as standard follow up

c. Remote monitoring did not significantly reduce the hospital costs per patient per year

d. Remote monitoring reduced mean non hospital costs per patient per year

7. Landolina M et al. Remote monitoring reduces healthcare use and improves quality of care in heart failure patients with implantable defibrillators: the evolution of management strategies of heart failure patients with implantable defibrillators (EVOLVO) study. Circulation. 2012;125: 2985-2992.


a. No significant annual cost savings for the health care system

b. Remote monitoring increased the efficiency of health care

c. Remote monitoring reduced the number of emergency department or urgent in-office visits and health care use

d. Significant reduction in the annual cost for patients and gained QALYs in the Remote monitoring arm

8. Hindricks G et al. Quarterly vs. yearly clinical follow-up of remotely monitored recipients of prophylactic implantable cardioverter-defibrillators: results of the REFORM trial. Eur Heart J. 2014;35:98-105.


a. No impact on mortality and hospitalization rate

b. Favorable impact of Remote monitoring on the quality of life

c. Remote monitoring safely reduces the ICD follow up burden for 27 months after implantation

9. Calò L et al. Economic impact of remote monitoring on ordinary follow-up of implantable cardioverter defibrillators as compared with conventional in-hospital visits: a single-center prospective and randomized study. J Interv Card Electrophysiol. 2013;37:69-78.


a. Remote monitoring significantly reduced the time spent by hospital staff and the costs of the hospital and patient

10. Hindricks G et al. Implant-based multiparameter telemonitoring of patients with heart failure (IN-TIME): a randomised controlled trial. Lancet. 2014;384:583-590.


a. Patients on home monitoring less likely to reach the composite end point of all-cause death, overnight hospital admission for heart failure, change in NYHA class and change in patient global assessment

b. Patients on home monitoring had lower mortality

c. Home monitoring did not reduce heart failure admissions

11. Lazarus A. Remote, wireless, ambulatory monitoring of implantable pacemakers, cardioverter defibrillators, and cardiac resynchronization therapy systems: analysis of a worldwide database (AWARE). Pacing Clin Electrophysiol. 2007;30:S2-S12.


a. Remote monitoring improved safety and optimized the allocation of health resources.

12. Saxon LA et al. Long-term outcome after ICD and CRT implantation and influence of remote device follow-up: the ALTITUDE survival study. Circulation. 2010;122:2359-2367.


a. Remote monitoring improves survival

13. Varma NPJ et al. The relationship between level of adherence to automatic wireless remote monitoring and survival in pacemaker and defibrillator patients. J Am Coll Cardiol. Inpress.Availableat: http://dx.doi. org/10.1016/j.jacc.2015.04.033.


a. Remote monitoring mediated survival is dose dependent on the degree of adherence but not on CIED complexity

For additional information please contact Adelaide Cardiology

Phone: 08 8202 6600 or

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