The Relationship Between Level of Adherence to Automatic Wireless Remote Monitoring and Survival in Pacemaker and Defibrillator Patients
The Relationship Between Level of Adherence to Automatic Wireless Remote Monitoring and Survival in Pacemaker and Defibrillator Patients
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DOI：
10.1016/j.jacc.2015.04.033
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发表时间：
2015-06-23
影响因子：
24
通讯作者：
Mittal, Suneet
中科院分区：
文献类型：
--
作者：
Varma, Niraj;Piccini, Jonathan P.;Mittal, Suneet
背景嵌入心律设备中的远程监测（RM）技术允许连续监测，这可能导致改善的患者预后。结论本研究使用“大数据”来评估RM是否与改善的生存率相关，以及这是否受心脏设备类型和/或其使用程度的影响。在2008年至2011年期间植入起搏器（PM）、植入式心律转复除颤器（ICD）或具有起搏功能（CRT-P）/除颤功能（CRT-D）的心脏除颤治疗（CRT）（带无线RM）的471例连续美国患者。我们通过按年龄分层的RM时间百分比（% TRM）分析了每种器械类型的每周使用和全因生存率。使用2012年的8个普查变量评估了对% TRM的社会经济影响。结果该组植入了PM（n = 115，076; 43%）、ICD（n = 85，014; 32%）、CRT-D（n = 61，475; 23%）和CRT-P（n = 7，906; 3%）。综合考虑，127，706例患者（47%）使用RM，其中67，920例（53%）TRM>= 75%（高% TRM），59，786例（47%）
BACKGROUND Remote monitoring (RM) technology embedded within cardiac rhythm devices permits continuous monitoring, which may result in improved patient outcomes.OBJECTIVES This study used "big data" to assess whether RM is associated with improved survival and whether this is influenced by the type of cardiac device and/or its degree of use.METHODS We studied 269,471 consecutive U.S. patients implanted between 2008 and 2011 with pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), or cardiac resynchronization therapy (CRT) with pacing capability (CRT-P)/defibrillation capability (CRT-D) with wireless RM. We analyzed weekly use and all-cause survival for each device type by the percentage of time in RM (% TRM) stratified by age. Socioeconomic influences on % TRM were assessed using 8 census variables from 2012.RESULTS The group had implanted PMs (n = 115,076; 43%), ICDs (n = 85,014; 32%), CRT-D (n = 61,475; 23%), and CRT-P (n = 7,906; 3%). When considered together, 127,706 patients (47%) used RM, of whom 67,920 (53%) had >= 75% TRM (high % TRM) and 59,786 (47%)