title: A Systematic Review of Economic Evaluations of Pacemaker Telemonitoring Systems.
abstract: OBJECTIVE
  Over the last decade, telemedicine applied to pacemaker monitoring has undergone extraordinary growth. It is not known if telemonitoring is more or less efficient than conventional monitoring. The aim of this study was to carry out a systematic review analyzing the available evidence on resource use and health outcomes in both follow-up modalities.
  
  
  METHODS
  We searched 11 databases and included studies published up until November 2014. The inclusion criteria were: a) experimental or observational design; b) studies based on complete economic evaluations; c) patients with pacemakers, and d) telemonitoring compared with conventional hospital monitoring.
  
  
  RESULTS
  Seven studies met the inclusion criteria, providing information on 2852 patients, with a mean age of 81 years. The main indication for device implantation was atrioventricular block. With telemonitoring, cardiovascular events were detected and treated 2 months earlier than with conventional monitoring, thus reducing length of hospital stay by 34% and reducing routine and emergency hospital visits as well. There were no significant intergroup differences in perceived quality of life or number of adverse events. The cost of telemonitoring was 60% lower than that of conventional hospital monitoring.
  
  
  CONCLUSIONS
  Compared with conventional monitoring, cardiovascular events were detected earlier and the number or hospitalizations and hospital visits was reduced with pacemaker telemonitoring. In addition, the costs associated with follow-up were lower with telemonitoring.
authors.affiliation: Division of Medicine, Nordland Hospital, Bodø, Norway; Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway. Electronic address: antoniolopezvillegas@andaluciajunta.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: López-Villegas
authors.affiliation: Departamento de Periodismo y Comunicación, Universidad Carlos III, Madrid, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Catalán-Matamoros
authors.affiliation: Unidad de Evaluación de Tecnología Sanitaria, Universidad Francisco de Vitoria, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Martín-Saborido
authors.affiliation: Unidad de Apoyo a la Investigación y Biblioteca, Hospital de Poniente, El Ejido, Almería, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Villegas-Tripiana
authors.affiliation: Unidad de Cuidados Intensivos, Hospital de Poniente, El Ejido, Almería, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Robles-Musso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay; D008297:Male; D018670:Monitoring, Ambulatory / Q000191:economics; D010138:Pacemaker, Artificial / Q000191:economics*; D016032:Randomized Controlled Trials as Topic; D017216:Telemedicine / Q000191:economics*
keywords: Cardiac output; Estudios de seguimiento; Follow-up studies; Gasto cardiaco; Marcapasos; Pacemaker