Cost savings and safety of ICD remote control by telephone: a prospective, observational study.
We examined the costs and safety of follow-up of patients with an implantable cardioverter defibrillator (ICD). In a prospective study, a remote monitoring system was used to interrogate ICD devices via telephone. Twenty patients with an ICD were followed up conventionally (clinic visits) or remotely at 1, 3 and 6 months after implantation of the ICD. A total of 30 transmissions of ICD data were made via the remote monitoring system. Five transmissions (17%) were interrupted, mainly due to a loss of telemetry, but no data were lost. The duration of the remote follow-up was 12.7 min less than follow-up in clinic (25.8 min, P < 0.05). Five of the remote follow-up transmissions concerned arrhythmia episodes. These lasted significantly longer than those without arrhythmia (16.6 vs. 4.9 min, P < 0.05). In three patients an unscheduled visit to the outpatient clinic was necessary. The cost of remote follow-up for 100 ICD patients/year was calculated to be €44,267, or about 16% of the cost of conventional in-clinic follow-up.
Bikou
Olympia
O
Department of Cardiology, University of Heidelberg, Heidelberg, Germany. Olympia.Bikou@med.uni-heidelberg.de
Licka
Manuela
M
Kathoefer
Sven
S
Katus
Hugo A
HA
Bauer
Alexander
A
D000368:Aged; D003362:Cost-Benefit Analysis; D017147:Defibrillators, Implantable / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006699:Home Care Services / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013686:Telemetry / Q000009:adverse effects / Q000191:economics / Q000379:methods; D013689:Telephone / Q000191:economics