Impact of remote monitoring on the management of arrhythmias in patients with implantable cardioverter-defibrillator

Background In the last decade, there has been an exponential increase in cardioverter-defibrillator (ICD) implants. Remote monitoring systems, allow daily followups of patients with ICD. Objective To evaluate the impact of remote monitoring on the management of cardiovascular events associated with supraventricular and ventricular arrhythmias during longterm follow-up. Methods A total of 207 patients undergoing ICD implantation/replacement were enrolled: 79 patients received remote monitoring systems and were followed up every 12 months, and 128 patients were followed up conventionally every 6 months. All patients were followed up and monitored for the occurrence of supraventricular and ventricular arrhythmia-related cardiovascular events (ICD shocks and/or hospitalizations). Results During a median follow-up of 842 days (interquartile range 476â€"1288 days), 32 (15.5%) patients experienced supraventricular arrhythmiaâ€"related events and 51 (24.6%) patients experienced ventricular arrhythmiaâ€"related events. Remote monitoring had a significant role in the reduction of supraventricular arrhythmiaâ€"related events, but it had no effect on ventricular arrhythmiaâ€"related events. In multivariable analysis, remote monitoring remained as an independent protective factor, reducing the risk of supraventricular arrhythmiaâ€"related events of 67% [hazard ratio, 0.33; 95% confidence interval (CI), 0.13â€"0.82; PU0.017]. Conclusion Remote monitoring systems improved outcomes in patients with supraventricular arrhythmias by reducing the risk of cardiovascular events, but no benefits were observed in patients with ventricular arrhythmias.