title: Reliability of implantable cardioverter defibrillator home monitoring in forecasting the need for regular office visits, and patient perspective. Japanese HOME-ICD study.
abstract: BACKGROUND
  Remote monitoring (RM) technology has emerged as a potentially efficient method to manage patients with implantable cardioverter defibrillators (ICDs) or cardiac resynchronization therapy defibrillators (CRT-Ds). This study evaluated the reliability of daily RM in forecasting the need for regular in-hospital follow-ups (RFUs).
  
  
  RESULTS
  Two hundred and fifteen patients implanted with Biotronik Lumax devices (142 ICDs, 73 CRT-Ds) were enrolled. RFU was performed at 3, 6, 9, and 12 months after implantation. Immediately before an RFU, the physician forecasted the need for RFU based on RM data (pre-RFU assessment). A completed RFU session was classified as necessary if an action was undertaken potentially influencing patient safety, device therapy, or medication therapy (post-RFU assessment). Overall, 663 pairs of pre- and post-RFU assessments were compared. The number of pre-RFU assessments failing to predict the need for RFU was 38 (5.7%), fulfilling the study hypothesis of 5.0±4.0% (P<0.002; 95% confidence interval: 4.1-7.8%). Judged by an independent committee, the rate of false pre-RFU forecasts with high clinical relevance was 2 (0.3%). RM correctly forecasted non-necessity of 498 scheduled RFUs (75.1%). Patient acceptance of RM was evaluated using a targeted questionnaire. Of 182 interviewed patients, 172 (94.5%) felt security and comfort.
  
  
  CONCLUSIONS
  RM-based forecasts appear sufficiently accurate to safely individualize RFU. Most patients have a positive attitude towards RM.
authors.affiliation: Department of Cardiology, Fujita Health University School of Medicine.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Watanabe
authors.forename: Atsunobu
authors.initials: A
authors.lastname: Kasai
authors.forename: Eitarou
authors.initials: E
authors.lastname: Fujii
authors.forename: Kohei
authors.initials: K
authors.lastname: Yamashiro
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D058998:Remote Sensing Technology / Q000379:methods*; D013997:Time Factors