Improving Remote Monitoring of Pacemakers: First Report of a Smartphone/Tablet-based Remote Monitoring System

Background: Remote monitoring (RM) of cardiac implantable electronic devices (CIED) reduces time to detection of clinically actionable events while also avoiding resources needed for clinic/hospital visits. RM initiation within 90 days post-implant is associated with improved mortality, yet, across various RM systems, studies show 40% of pacemaker patients fail to initiate RM within 90 days due to patient non-compliance, technical issues, and user interface confusion. We evaluated the performance of a new RM system that is controlled by the patient’s smartphone or tablet (MyCareLink Smart, MCLS). Methods: Patients with Medtronic pacemakers at 7 US clinics were recruited from March to July 2015 to undergo remote transmission with the MCLS system. MCLS consists of a handheld reader that interrogates the pacemaker and sends the data via Bluetooth to the patient’s smartphone/tablet which in turn transmits the data to the CareLink RM system via WiFi or cellular connection. Each patient was asked to send two transmissions, one month apart. Patient compliance to transmissions was analyzed and survey feedback from patients and clinicians was collected. Results: In this study, 629 patients were screened; of which, 340 (54%) had access to a smartphone or tablet and 201 participated. Age was collected in 5 year intervals. The patient median age interval was 65-70 years and 53% were male. Of these patients, 85.6% of patients completed a first transmission. Overall, of 389 total planned transmissions, 295 (75.8%) were attempted and successfully completed. Patients who underwent on-site training with a test transmission had better adherence to the planned transmission schedule compared to patients who were sent home with set-up instructions (92.2% vs 64.1%; p Conclusions: In the first report of a smartphone/tablet-based remote monitoring system, we observed a high prompt initiation rate (85.6%) and overall transmission schedule adherence (75.8%) across multiple centers. Over half of patients in this demographic already had access to a personal smartphone or tablet.