Smartphone-based cied remote monitoring: improved compliance and connectivity

Abstract Objective Remote monitoring (RM) is the standard of care for follow up of patients with cardiac implantable electronic devices. The aim of this study was to compare smartphone-based RM (SM-RM) using patient applications (myMerlinPulseTM app) with traditional bedside monitor RM (BM-RM). Methods The retrospective study included de-identified U.S. patients who received either SM-RM or BM-RM capable implantable cardioverter defibrillators or cardiac resynchronization therapy defibrillators (Abbott, USA). Patients in SM-RM and BM-RM groups were propensity-score matched on age and gender, device type, implant year and month. Compliance with RM was quantified as the proportion of patients enrolling in the RM system (Merlin.netTM) and transmitting data at least once. Connectivity was measured by the median number of days between consecutive transmissions per patient. Results Of the initial 9,714 patients with SM-RM and 26,679 patients with BM-RM, 9,397 patients from each group were matched. RM compliance was higher in SM-RM; significantly more patients with SM-RM were enrolled in RM compared to BM-RM (94.4% vs. 85.0%, p < 0.001), similar number of patients in the SM-RM group paired their device (95.1% vs. 95.0%, p = 0.77), but more SM-RM patients transmitted at least once (98.1% vs. 94.3%, p < 0.001). Connectivity was significantly higher in the SM-RM, with patients transmitting data every 1.2 [1.1, 1.7] vs. every 1.7 [1.5, 2.0] days with BM-RM (p < 0.001) and remained better over time. Significantly more SM-RM patients utilized patient-initiated transmissions compared to BM-RM (55.6% vs. 28.1%, p < 0.001). Conclusion In this large real-world study, patients with SM-RM demonstrated improved compliance and connectivity compared to BM-RM.