Effectiveness and safety of remote monitoring of patients with an implantable loop recorder.
OBJECTIVE
Implantable loop recorders have proven efficacy in the study of patients with syncope and palpitations. Remote monitoring of patients with pacemakers and implantable cardioverter-defibrillators has been shown to be safe and effective. The purpose of this study was to analyze the safety and effectiveness of remote monitoring in patients with an implantable loop recorder.


METHODS
Retrospective observational study in which 109 patients with an implantable loop recorder were analyzed and 2 population groups were compared: 1 receiving conventional follow-up consisting of 3-monthly office visits (41 patients) and 1 with remote monitoring via monthly telephone transmissions and yearly visits (68 patients). The mean follow-up was 64 weeks (range, 0.57-164.57 weeks). The study analyzed diagnosis of a significant event, defined as any event that led to a therapeutic approach and explained the symptoms leading to the implant, as well as the mean time from implant to diagnosis and the specific treatment.


RESULTS
A significant event was diagnosed in 82.6% of patients; of these, 54.4% had a normal electrocardiogram; 26.7%, asystole; 15.6%, tachycardia, and 3.3%, bradycardia. The mean time from implant to diagnosis was 260 days (range, 5-947 days) in conventional follow-up, compared with 56 days (range, 0-650 days) in patients with remote monitoring (P<.01), which led to targeted treatment in this group 187 days earlier, on average, with no secondary complications.


CONCLUSIONS
Remote monitoring of patients with an implantable loop recorder can significantly shorten the time to diagnosis and targeted treatment, without adversely affecting patient safety.
Servicio de Cardiología, Unidad de Arritmias, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. Electronic address: yasmindrakhernandez@hotmail.es.
Yasmín
Y
Drak-Hernández
Servicio de Cardiología, Unidad de Arritmias, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
Jorge
J
Toquero-Ramos
Servicio de Cardiología, Unidad de Arritmias, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
José M
JM
Fernández
Servicio de Cardiología, Unidad de Arritmias, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
Elena
E
Pérez-Pereira
Servicio de Cardiología, Unidad de Arritmias, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
Víctor
V
Castro-Urda
Servicio de Cardiología, Unidad de Arritmias, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
Ignacio
I
Fernández-Lozano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000628:therapy*; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017147:Defibrillators, Implantable; D004562:Electrocardiography / Q000379:methods; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000002:abnormalities*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods; D010138:Pacemaker, Artificial; D058998:Remote Sensing Technology / Q000295:instrumentation*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013637:Tape Recording / Q000295:instrumentation; D017216:Telemedicine / Q000295:instrumentation; D016896:Treatment Outcome
CF; Holter insertable; ICD; ILR; Implantable loop recorder; Monitorización a distancia; PM; Palpitaciones; Palpitations; RM; Remote monitoring; Syncope; Síncope; conventional follow-up; implantable cardioverter-defibrillator; implantable loop recorder; pacemaker; remote monitoring