title: Impact of remote monitoring on the management of arrhythmias in patients with implantable cardioverter-defibrillator.
abstract: BACKGROUND
  In the last decade, there has been an exponential increase in cardioverter-defibrillator (ICD) implants. Remote monitoring systems, allow daily follow-ups 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 long-term 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 476-1288 days), 32 (15.5%) patients experienced supraventricular arrhythmia-related events and 51 (24.6%) patients experienced ventricular arrhythmia-related events. Remote monitoring had a significant role in the reduction of supraventricular arrhythmia-related events, but it had no effect on ventricular arrhythmia-related events. In multivariable analysis, remote monitoring remained as an independent protective factor, reducing the risk of supraventricular arrhythmia-related events of 67% [hazard ratio, 0.33; 95% confidence interval (CI), 0.13-0.82; P = 0.017].
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, S. Anna Hospital, University of Ferrara, Cona, Ferrara, Italy.
authors.forename: Lina
authors.initials: L
authors.lastname: Marcantoni
authors.forename: Tiziano
authors.initials: T
authors.lastname: Toselli
authors.forename: Giulia
authors.initials: G
authors.lastname: Urso
authors.forename: Claudio
authors.initials: C
authors.lastname: Pratola
authors.forename: Claudio
authors.initials: C
authors.lastname: Ceconi
authors.forename: Matteo
authors.initials: M
authors.lastname: Bertini
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000517:prevention & control*; D017147:Defibrillators, Implantable / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008134:Long-Term Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D058998:Remote Sensing Technology / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors