March 04, 2019
2 min read
Save

RM-ALONE: Remote monitoring protocol safe, efficient

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

A remote monitoring protocol with remote instead of in-office interrogations every 6 months was safe and reduced hospital visits and staff workload at 2 years, according to the results of the RM-ALONE trial.

“The 2-year results from RM-ALONE demonstrate that remote monitoring with remoteinterrogations may be a safe substitute for conventional in-person follow-ups of patients with cardiac implants,” Francisco Javier García-Fernández, MD, PhD, from the arrhythmia unit, department of cardiology, Hospital Universitario de Burgos in Spain, said in a press release. “Our results now raise the question of whether the current guidelines for [cardiac implantable electronic devices] should be adjusted according to our latest research findings.”

The researchers randomly assigned 445 patients (mean age, 73 years; 64% men) with a pacemaker or implantable cardioverter defibrillator to home monitoring only, with remote monitoring supplemented by remote interrogations every 6 months (Biotronik Home Monitoring, Biotronik), or home monitoring plus in-office visits, with remote monitoring supplemented by in-office visits every 6 months.

At 2 years, the groups had similar rates of major adverse cardiac events, defined as all-cause death, stroke, hospitalization caused by the device or a cardiac issue and device-related surgical infection (home monitoring-only group, 20%; office visit group, 19.5%; P for noninferiority = .006), the researchers wrote.

Among those with pacemakers, 15.2% of the home monitoring-only group and 16.1% of the office visit group had at least one major adverse cardiac event during the study period (HR = 0.95; 95% CI, 0.53-1.7), whereas among those with ICDs, the rates were 29.3% for the home monitoring-only group and 26.3% for the office visit group (HR = 1.15; 95% CI, 0.62-2.1), according to the researchers.

There were 136 in-office evaluations for the home monitoring-only group vs. 653 for the office visit group, a reduction of 79.2% (P < .001), García-Fernández and colleagues found.

Unscheduled in-office visits did not differ between the groups (home monitoring only, 122; office visit, 101; P = .15).

Mean time spent by physicians per patient on the total amount of follow-ups was 5.9 minutes in the home monitoring-only group and 10.2 minutes in the office visit group (P < .0001), whereas mean time spent by nurses per patient on the total amount of follow-ups was 6.3 minutes in the home monitoring-only group and 11.1 minutes in the office visit group (P < .0001), according to the researchers. The trends were similar in the pacemaker cohort and the ICD cohort. – by Erik Swain

Disclosures: The study was funded by Biotronik. García-Fernández reports he received a research grant from Biotronik and consultant/adviser fees from Boston Scientific and Medtronic. Please see the study for all other authors’ relevant financial disclosures.