For the first time, the relationship between remote monitoring and pacemaker patient survival outcomes is revealed in a Late Breaking study released at Heart Rhythm 2014, the Heart Rhythm Society's 35th Annual Scientific Sessions.

In the trial on patients implanted with either pacemakers or defibrillators demonstrated that high adherence to remote monitoring more than doubled the probability of survival compared to patients without remote monitoring.  The study shows that the utilization of remote monitoring can improve survival outcomes in patients with pacemakers. Furthermore, survival rates improved in patients with the highest engagement rates in remote monitoring, regardless of device type.

Approximately 600,000 people worldwide are implanted with pacemakers each year.  Remote monitoring allows doctors to monitor a patient's device between follow-up visits and alerts them to any issues via wireless technology. Over the past decade, pacemakers have become more advanced, allowing for compatibility with all devices, and enrollment in remote monitoring has become accessible to all patients. While previous studies have shown remote monitoring to be associated with reduced mortality in implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) patients, it has been unknown whether this relationship applies to pacemaker patients.

In this trial, over 260,000 patients (262,574) with a St. Jude Medical pacemaker (112,692 patients), cardiac resynchronization pacemaker (CRT-P) (7,704 patients), ICD (82,621 patients) or CRT-D (59,547 patients) device were enrolled in remote monitoring surveillance. Remote monitoring service utilization data was collected on a weekly basis and evaluated to determine the rate of engagement among patients. Survival rates were prospectively compared for each device type among patients with high, low or no remote monitoring service utilization.

Patients with high adherence to remote monitoring – measured as weekly transmission of patient data from the Merlin@Home System to the Merlin.net™ Patient Care Network at least 75 percent of the time – overall had a 58 percent reduced likelihood of mortality than patients not using remote monitoring and a 35 percent reduced likelihood of mortality than patients with low remote monitoring. Though there was geographic variability, socioeconomic factors were not associated with remote monitoring use.

"The scope of our study and resounding results shows, for the first time, how valuable remote monitoring can be for pacemaker patients. It is imperative that clinicians inform patients about the benefits and accessibility of remote monitoring technology," said lead author Suneet Mittal, MD, FHRS, Director of Electrophysiology Laboratory at The Valley Hospital Heart & Vascular Institute. "This trial can serve as initial evidence that remote monitoring not only improves the survival of patient's regardless of device type, but also change the way in which we are able to deliver care."

The reasons for this positive association require further investigation as they may have important implications for individual patient care and best practices.  Future studies and research should be initiated in order to help increase remote monitoring participation rates and raise awareness about the positive impact of remote monitoring.