Remote interrogation and monitoring of implantable cardioverter defibrillators

Context: The rate of ICD implantation of has grown substantially after results of primary and secondary prevention trials have demonstrated mortality superiority over pharmacologic therapy. Although transtelephonic monitoring is routine for pacemaker follow-up there is no systematically collected data supporting remote interrogation and monitoring (RIM) of ICD patients. Objective: To prospectively measure the physician and patient acceptability, diagnostic value and safety of systematic periodic RIM of ICDS. Methods: 124 patients with single chamber ICDs were monitored by remote RIM and by annual outpatient ICD analysis. Patients could initiate additional remote interrogations due to symptoms and physicians could increase the frequency of remote interrogations to monitor elective replacement indicators or if the device was identified as requiring more frequent follow-up. Outpatient clinic analysis was used to investigate abnormal remote interrogations. Main Outcome Measures: SF-36 and patient satisfaction surveys were obtained at baseline, at 3 and 6 months. Results: 570 transmissions (5.1+2.4 per patient) were received and showed 54 delivered and 22 aborted ICD therapies and 30 episodes of NSVT. SF-36 results were no different at baseline, 3 and 6 months. Out of the total patients enrolled in the study, 93-99% of patients indicated complete or high satisfaction with remote interrogation in the five measures used to gauge satisfaction. Conclusions: Remote ICD interrogation provides frequent, convenient, safe and comprehensive monitoring. Device and patient related problems were reliably detected and reduced the frequency of outpatient visits. Patients were highly satisfied with the convenience and ease of use of the system.