title: Findings of an observational investigation of pure remote follow-up of pacemaker patients: is the in-clinic device check still needed?
abstract: BACKGROUND
  Device follow-up is mandatory in the care of patients with a pacemaker. However, in most cases, device checks appear to be mere technical, time-consuming procedures. The aim of this research is to evaluate whether remote follow-up can replace in-clinic device checks by assessing clinical outcomes for pacemaker patients followed only via remote follow-up.
  
  
  RESULTS
  Consecutive pacemaker patients followed with remote monitoring were prospectively included by 6 Italian cardiology centers in an observational investigation. The workflow for remote monitoring included an initial assessment by nursing staff and, when necessary, by a responsible physician for medical decisions. No in-person visits were scheduled after the start of remote monitoring. One-thousand and two-hundred and fifty one patients (30% female, 75±11years old) were followed for a median observation period of 15months. Out of 4965 remote transmissions, 1882 (38%) had at least one clinically relevant event to be investigated further, but, only after 137 transmissions (2.8%), the patients were contacted for an in-clinic visit or hospitalization. Sixty-nine patients died and 124 were hospitalized for various reasons. Atrial fibrillation episodes were the most common clinical events discovered by remote transmissions, occurring in 1339 (26%) transmissions and 471 (38%) patients.
  
  
  CONCLUSIONS
  Our experience shows that remote monitoring in a pacemaker population can safely replace in-clinic follow-up, avoiding unnecessary in-hospital device follow-up.
authors.affiliation: Azienda Sanitaria Universitaria Integrata di Udine, Italy. Electronic address: facchin.domenico@aoud.sanita.fvg.it.
authors.forename: D
authors.initials: D
authors.lastname: Facchin
authors.affiliation: Ospedale P. Cosma, Camposampiero, Italy.
authors.forename: M S
authors.initials: MS
authors.lastname: Baccillieri
authors.affiliation: Ospedale dell'Angelo, Mestre, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gasparini
authors.affiliation: Azienda Ospedaliera di Mirano, Mirano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Zoppo
authors.affiliation: Ospedale di Conegliano, Conegliano, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Allocca
authors.affiliation: Ospedale Santa Maria degli Angeli, Pordenone, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Brieda
authors.affiliation: Ospedale P. Cosma, Camposampiero, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Verlato
authors.affiliation: Azienda Sanitaria Universitaria Integrata di Udine, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Proclemer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D017147:Defibrillators, Implantable / Q000592:standards / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000639:trends*; D010138:Pacemaker, Artificial / Q000592:standards* / Q000639:trends*; D011446:Prospective Studies; D019114:Remote Consultation / Q000379:methods / Q000592:standards* / Q000639:trends*
keywords: Pacemakers; Remote follow-up; Remote interrogation; Remote monitoring