Home Monitoring of Heart Device May Be Safe
Studies Show Remote Monitoring of Implantable Cardioverter Defibrillators May Extend Battery Life
Home ICD Monitoring Studies continued...
Researcher Salem Kacet, MD, of Regional University Hospital of Lille, in France, tells WebMD that overall, home monitoring was associated with a reduction in the number of shocks "with a significant impact on ICD battery longevity."
But information on how long battery life was extended and potential cost savings is still being analyzed, he says. ICD batteries typically last between five and seven years. Replacing them requires surgery, typically with anesthesia and antibiotics to prevent infection.
The second study, dubbed EVATE by Mabo, involved 1,501 patients. They were divided into two groups: the remote follow-up group, whose ICD data were transmitted to the clinic every three months, and the usual-care group, who had office follow-up visits every three months.
Thirty percent of people in the remote monitoring group died or were hospitalized for cardiovascular disease vs. 29% of the usual-care group, a difference so small it could have been due to chance.
There was also no difference in survival rates among the two groups.
However, people in the remote group were less likely to receive heart-rhythm medication they didn't need based on erratic device readings: 5% vs. 8% of the usual-care group.
Cost May Be an Issue
Commenting on the studies, American Heart Association (AHA) spokeswoman Mariell Jessup, MD, of the University of Pennsylvania, says that reducing inappropriate shocks and medication use is "really important, as that's what we as doctors want to avoid."
Still, there may be cost concerns with the routine use of home monitoring, she tells WebMD.
AHA President Gordon Tomaselli, MD, of Johns Hopkins University, says that at least in the short-term, he expects home monitoring to raise costs.
Noting that his practice already remotely monitors patients who live far away, he says, "we get a boatload of data every day, potentially every heartbeat."
As a result, "more staff that can catch and interpret the ICD data and feed it to the doctors is needed," Tomaselli tells WebMD. "And that costs money."
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.