Introduction: The use of remote monitoring (RM) of implantable cardiac implantable electronic devices (CIEDs) has been associated with improvement in clinical outcomes. CMS and professional society guidelines recommend CIED follow up within 90 days of device implant. However, enrollment in RM is not optimal and there is currently no standard with how it is implemented.
Hypothesis: Providing remote monitor units with cellular adaptors as a bundled service following CIED implantation will improve remote transmission rate.
Methods: Patients undergoing CIED (implantable cardioverter-defibrillators and pacemakers) implantations at our institution from January 2011 to December 2016 were prospectively followed. In 2012, remote monitoring was standardized and included providing a remote monitor unit including a universal cell phone adaptor at the time of discharge. Patients were stratified by those undergoing CIED prior to and after the years following intervention. Transmission rates at 90 days and 1 year were calculated and analysis was performed using Chi squared test.
Results: Compared to patients the year before (n=364) implementation of cell phone adaptor, those for the year after (n=396) had a significant improvement in rate of transmission within 90 days, 21 (7%) vs.71 (25%), p<0.01, and within 1 year, 94 (26%) vs. 181 (45%), p <0.01. Improvement in the rate of 90 day transmissions was significant for each consecutive year following 2013 (p<0.01 for each year compared to pre-implementation). There was no significant association between age category and proximity to the hospital for remote transmissions within one year.
Conclusions: The use of a remote monitoring bundled package including free access to cellular phone adaptors at the time of discharge significantly improved the rate of remote transmission and compliance of first remote at 90 days as well as overall follow up.