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Oct 04, 2013

Few ICD Patients Utilize New Safety Feature

Study finds less than half of patients with implantable cardioverter-defibrillators are using remote patient monitoring.

Implantable cardioverter-defibrillators (ICDs) can be life-saving for patients at increased risk of sudden cardiac death, but few take advantage of a new widely-available safety feature that can help improve outcomes, according to a recent study.

Published in the American Heart Association’s medical journal, Circulation, this study analyzed usage trends of a new technology called remote patient monitoring, which allows critical information like heart rhythm and battery life to be continuously monitored in between doctor visits. For patients with ICDs, home monitoring not only helps with early detection of device malfunctions but it reduces the burden of frequent doctor visits. Most patients with ICDs visit their doctor every three to six months to assess device function, and home monitoring can help replace at least some of these regular appointments. Currently, all ICDs are capable of remote monitoring, so why aren’t more patients taking advantage of it?

The Boston Scientific Corporation, American College of Cardiology Foundation and Yale/New Haven Hospital Center for Outcomes Research and Evaluation teamed up to help answer this puzzling question and here’s what they found. Among more than 39,000 patients who received ICDs in recent years and enrolled in the study, only 62% signed up for remote monitoring and among those enrolled, only 76% actually activated the monitoring device. That’s less than half of all patients with ICDs taking advantage of home monitoring capabilities.

Interestingly, a few different factors played a key role in which patients ultimately utilized remote monitoring. Where they received their ICD had a big impact on enrollment rates, meaning certain hospitals encouraged enrollment into the program more than others. But once patients enrolled, factors like age, race, and location played a more important role in which patients activated their devices. 

Although experts are disappointed by the clear under-utilization of this safety feature, study findings highlight opportunities to help improve outcomes for patients with ICDs. Most importantly, we need to ensure that all hospitals giving patients ICDs encourage (or even require) patients to enroll in remote monitoring. The more patients are strongly advised to take advantage of this safety feature, the more will actually enroll. But that alone won’t solve the problem. Education and follow-up are needed to help ensure that patients who sign up for home monitoring actually activate their devices. By taking steps to address these key barriers, more patients with ICDs will take advantage of remote monitoring, helping to reduce risk of complications from the device and improve outcomes.

Questions for You to Consider

  • What is an implantable cardioverter defibrillator (ICD)?
  • An ICD is a device that uses electrical pulses or shocks to help patients with an irregular heartbeat maintain normal heart rhythm. Upon detecting an abnormal heart rhythm, ICDs send shocks to the heart to help restore normal rhythm and prevent sudden cardiac death.
  • What is sudden cardiac death?

  • Sudden cardiac death can result from sudden cardiac arrest, when the heart suddenly and unexpectedly stops beating. Sudden cardiac arrest must be immediately addressed with CPR and medical attention to improve chances of survival.

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