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Utilization of the Remote Monitoring of Cardiac Implantable Electronic Devices in a Diverse Demographic Cohort: Insights from a Single-Center Observation
  • +13
  • Jiyoung Seo,
  • Majd Al Deen Alhuarrat,
  • Suraj Krishnan,
  • Tinatin Saralidze,
  • Hyomin Lim,
  • Brett Chen,
  • David Flomenbaum,
  • Ahmad Naser,
  • Amrin Kharawala,
  • Samuel J. Apple,
  • Neal Ferrick,
  • Jay Chudow,
  • Luigi Di Biase,
  • John Fisher,
  • Andrew Krumerman,
  • Kevin Ferrick
Jiyoung Seo
New York City Health and Hospitals Jacobi

Corresponding Author:jiyoungseo1119@gmail.com

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Majd Al Deen Alhuarrat
New York City Health and Hospitals Jacobi
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Suraj Krishnan
New York City Health and Hospitals Jacobi
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Tinatin Saralidze
New York City Health and Hospitals Jacobi
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Hyomin Lim
New York City Health and Hospitals Jacobi
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Brett Chen
Montefiore Medical Center
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David Flomenbaum
Montefiore Medical Center
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Ahmad Naser
New York City Health and Hospitals Jacobi
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Amrin Kharawala
New York City Health and Hospitals Jacobi
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Samuel J. Apple
New York City Health and Hospitals Jacobi
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Neal Ferrick
Montefiore Medical Center
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Jay Chudow
Montefiore Medical Center
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Luigi Di Biase
Montefiore Medical Center
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John Fisher
Montefiore Medical Center
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Andrew Krumerman
Montefiore Medical Center
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Kevin Ferrick
Montefiore Medical Center
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Abstract

Background Despite its clinical benefits, patient compliance to remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) varies and remains under-studied in diverse populations. Objective We sought to evaluate RM compliance, clinical outcomes, and identify demographic and socioeconomic factors affecting RM in a diverse urban population in New York. Methods This retrospective cohort study included patients enrolled in CIED RM at Montefiore Medical Center between December 2017 and May 2022. RM compliance was defined as the percentage of days compliant to RM transmission divided by the total prescribed days of RM. Patients were censored when they were lost to follow-up or at the time of death. The cohorts were categorized into low (≤30%), intermediate (31-69%), and high (≥70%) RM compliance groups. Statistical analyses were conducted accordingly. Results Among 853 patients, median RM compliance was 55%. Age inversely affected compliance (p<0.001), and high compliance was associated with guideline-directed medical therapy (GDMT) usage and implantable cardioverter defibrillator (ICD)/ cardiac resynchronization defibrillator (CRTD) devices. The low-compliance group had a higher mortality rate and fewer regular clinic visits (p<0.001) than high-compliance group. Socioeconomic factors did not significantly impact compliance, while Asians showed higher compliance compared with Whites (OR 3.67; 95% CI 1.08-12.43; p=0.04). Technical issues were the main reason for non-compliance. Conclusion We observed suboptimal compliance to RM, which occurred most frequently in older patients. Clinic visit compliance, optimal medical therapy, and lower mortality were associated with higher compliance, whereas insufficient understanding of RM usage was the chief barrier to compliance.