A report on the impact of remote monitoring in patients with S‐ICD: Insights from a prospective registry. Issue 3 (15th January 2019)

• Record Type: Journal Article
• Authors: Ninni, Sandro; Delahaye, Camille; Klein, Cédric; Marquie, Christelle; Klug, Didier; Lacroix, Dominique; Brigadeau, François; Potelle, Charlotte; Kouakam, Claude; Finat, Loïc; Guedon‐Moreau, Laurence
• Is Part Of: Pacing and clinical electrophysiology. Volume 42:Issue 3(2019)
• Page Start: 349
• Page End: 355
• Publication Date: 2019-01-15
• Subjects: implantable cardioverter defibrillator -- remote monitoring -- subcutaneous ICD; Cardiac pacing -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1111/pace.13598
• Languages: English
• ISSNs: 0147-8389

Abstract

Abstract: Introduction: Several clinical studies have demonstrated that remote monitoring (RM) offers potential benefits in transvenous implantable cardioverter defibrillator (ICD). The potential interest of RM in subcutaneous‐ICD (S‐ICD) recipients has never been evaluated. The aim of this study was to evaluate the alert burden and its clinical relevance in a prospective cohort of S‐ICD recipients. Methods: We prospectively and consecutively enrolled all patients undergoing S‐ICD implantation at Lille University Hospital from September 2015 to January 2017 and gave them a LATITUDE™ NXT RM system. The relevance of transmissions was assessed by the following ratio: number of transmissions leading to reaction or intervention per patient/number of transmissions per patient. Results: From September 2015 to January 2017, 69 patients were enrolled with a mean follow‐up of 415 ± 96.3 days. The mean age was 44.6 ± 15.6 years old, and 25% (n = 17) had ischemic cardiomyopathy. At the end of follow‐up, 12% of the patients had events recorded by RM. These events were related to nine ICD shocks and eight untreated events. A total of 1, 423 transmissions were collected. Most of these transmissions were patient‐initiated without any event (77%, n = 1, 096) or scheduled without any event (19%, n = 272). Only 3.2% ± 1.1 of the transmissions per patient led to reactions or interventions. Conclusion: On the basis of the current method of transmitting, S‐ICD RM allowed detection of relevant events in 12% of patients but generated a high unactionable transmission burden. As a result of these findings, efforts should be made to optimize transmissions considering automatic transmissions and to focus on patient education.