Preprint Article Version 1 This version is not peer-reviewed

Smartphone App-Based Remote Monitoring Challenges in Patients with Cardiac Resynchronization Therapy Defibrillator – a Multicenter Study

Dagmar Kowal
ORCID logo ,
Marek Prech
,
Agnieszka Katarzyńska-Szymańska
,
Artur Baszko
,
Grzegorz Skonieczny
,
Elżbieta Wabich
,
Maciej Kempa
,
Błażej Rubiś
* ORCID logo ,
Przemysław Mitkowski
Version 1 : Received: 8 October 2024 / Approved: 8 October 2024 / Online: 8 October 2024 (15:04:26 CEST)

How to cite: Kowal, D.; Prech, M.; Katarzyńska-Szymańska, A.; Baszko, A.; Skonieczny, G.; Wabich, E.; Kempa, M.; Rubiś, B.; Mitkowski, P. Smartphone App-Based Remote Monitoring Challenges in Patients with Cardiac Resynchronization Therapy Defibrillator – a Multicenter Study. Preprints 2024, 2024100586. https://doi.org/10.20944/preprints202410.0586.v1 Kowal, D.; Prech, M.; Katarzyńska-Szymańska, A.; Baszko, A.; Skonieczny, G.; Wabich, E.; Kempa, M.; Rubiś, B.; Mitkowski, P. Smartphone App-Based Remote Monitoring Challenges in Patients with Cardiac Resynchronization Therapy Defibrillator – a Multicenter Study. Preprints 2024, 2024100586. https://doi.org/10.20944/preprints202410.0586.v1

Abstract

Background/Objectives: Remote monitoring (RM) of cardiac implantable electronic devices for adults offers improved patient outcomes. However, bedside transmitters utilized so far are not optimal due to limited patient adherence. The goal of this study was to evaluate the efficacy of RM regarding the connectivity of smartphone app-based solutions, adherence to planned automatic follow-ups, and occurrence of alert-based events. Methods: We evaluated the adult heart failure (HF) population with implanted cardiac resynchronization therapy defibrillator (CRT-D) divided into two arms: with app-based RM (abRM) and without app-based RM (control). Results: A total of 81 patients (median age of 69.0) were included in our study. 65 patients received a CRT-D with abRM functionality, and 16 did not. 12 patients had no smartphone, and 2 provided no consent, resulting in their transfer to the control group. Finally abRM arm consisted of 51 patients, while 30 patients were in the control group. Median period of follow-up lasted 12 months. Among abRM patients, 98.0% successfully transmitted their first scheduled follow-up, and 80.4% were continuously monitored. Alert-based events were mainly related to arrhythmic events and device functionality with significantly shorter median time to notification (1 day vs. 101 days; p<0.0001) in the abRM group. Conclusions: Our study showed a high level of compliance with timely initial transmission and adherence to scheduled remote follow-ups. Patient enrollment eligibility was a major challenge due to the limited accessibility of smartphones in the population. App-based RM demonstrated an accurate notification of events and patient-initiated transmissions in emergencies, regardless of location.

Keywords

Bluetooth; cardiac resynchronization therapy; heart failure; remote monitoring; smartphone app

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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