From in-clinic to fully remote follow-up model for pacemaker patients: A four-year experience

Abstract Background Guidelines on remote monitoring (RM) still suggest at least 1 in-person visit per year for all remotely followed patients, including pacemaker patients. Methods The RM of pacemaker patients was systematically introduced in our clinic since January 2013. Patients without RM were visited 2 months after implantation and afterwards annually. Subjects with RM had in-person visit only at 2-month follow-up and at device replacement. Results At the end of 2016 a total of 2233 patients (mean age 81.4 ± 9.9 years, 55% male) were followed by our centre. The patient population had a mean annual growth of 2.8 ± 2.3% with an incidence of RM increasing from 0% in 2012 to 45% in 2016. The in-clinic visits significantly decreased from the second year (I year: −12, 0%; II year: −324, −17%; III year: −276, −17%, IV year: −127, −10%). The annual incidence of unscheduled ambulatory visit for patients with RM was 15.9 ± 2.9%, mainly triggered by device reprogramming, transmission problems and autocapture deactivation. There was no effect on the incidence of serious adverse events and mortality. Conclusions This fully remote follow-up model for pacemaker patients reduced in-clinic visits since the second year from its implementation in our clinical practice. This strategy may increase the organizational benefits of RM in low-risk patients.