Remote Care

Remote Cardiac Monitoring Gains Momentum

The last week featured two of the world’s largest heart failure and electrophysiology conferences, each driving a surge of new papers and studies suggesting that remote monitoring is moving to the forefront of both cardiology subspecialties.

CIED Remote Monitoring Consensus – The leading global Heart Rhythm societies released a long-awaited update to their Consensus Statement on the remote monitoring of patients with CIEDs (the first update since 2015). The CIED RM statement goes into incredible detail, while placing new or strengthened emphasis on:

  • Confirming that RM remains the standard of care for patients with CIEDs
  • Maintaining adequate, dedicated, and trained RM staff
  • Educating RM patients and their caregivers
  • Ensuring reliable and continuous CIED connectivity and communications
  • Strengthening collaborations across all RM stakeholders
  • Highlighting the benefits of third party RM platforms
  • And more…

Implicity’s CIED RM Advantage – Remote monitoring might be “the standard of care” for patients with CIEDs, but outcomes from different RM platforms are far from standardized. Implicity’s analysis of over 68k patients with CIEDs found that those monitored using the Implicity platform had significantly better one-year outcomes than patients monitored using platforms provided by CIED manufacturers, including:

  • 22% lower all cause mortality rates (even after confounding factor adjustments)
  • 4% fewer annual hospitalizations per patient
  • 6% fewer annual hospitalization days per patient 

Remote HF Monitoring Evidence – Data from the MONITOR-HF trial showed that remote pulmonary artery pressure monitoring improves chronic heart failure patients’ quality of life and reduces their need for medical care. Among 348 patients in the Netherlands with chronic heart failure, those randomized for monitoring with Abbott’s CardioMEMS-HF system had:

  • Far higher KCCQ quality of life scores than the usual care group after one year (+7.05 vs. -0.8; the primary endpoint)
  • Fewer heart failure hospitalizations (117 vs. 212) and urgent visits (11 vs. 17) than the usual care group after 1.8 years .

The MONITOR-HF trial provides the first European evidence supporting PAP-based HF monitoring, and largely matches the results from previous U.S. trials, which the researchers suggest should drive adoption in Europe.

Extended ECG Monitoring for HCM – iRhythm’s EXAMINE-HCM study highlighted the benefits of long-term ECG monitoring among patients with hypertrophic cardiomyopathy (HCM). Analysis of HCM patients monitored using iRhythm’s Zio XT service showed that 14-day monitoring achieved far higher diagnostic yields than only monitoring during the first 48 hours for detecting non-sustained ventricular tachycardia (NSVT) and high-risk NSVT (48% vs. 14% & 24% vs. 8%).

  • The additional identification of high risk NSVT episodes over more extended monitoring periods has potential impact on sudden death risk stratification in HCM patients.
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-- The Cardiac Wire Team