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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EUse of a remote monitoring (RM) program in patients with an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy-defibrillator (CRT-D) was associated with increased survival, regardless of device type and socioeconomic status. This article presentz data from a study of adherence to remote monitoring of patients with a pacemaker or defibrillator.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EArrhythmias\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EArrhythmias\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology \u0026amp; Cardiovascular Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EUse of a remote monitoring (RM) program in patients with an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy-defibrillator (CRT-D) was associated with increased survival, regardless of device type and socioeconomic status. Suneet Mittal, MD, Valley Health System of New York and New Jersey, New York, New York, USA, presented data from a study of adherence to remote monitoring of patients with a pacemaker or defibrillator.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EA previous study demonstrated that enrollment in a remote monitoring program was associated with improved survival in patients with an ICD or cardiac CRT-D [Saxon LA et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2010]. The purpose of this current study was to examine the association between adherence to remote monitoring and survival and to explore potential mechanisms between remote monitoring and improved outcomes.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn this prospective observational cohort study, patients (n=262,562) with a wireless pacemaker, CRT-pacemaker, ICD, or CRT-D device capable of remote monitoring with the \u003Ca href=\u0022http:\/\/Merlin.net\u0022\u003EMerlin.net\u003C\/a\u003E Patient Care Network were followed from device implantation (between 2009 and 2011) to follow-up (up to November 2012). Device-tracking data included age, sex, implant date, device type, follow-up duration, and postal zip code. US Census data were used to link zip code to race, education level, employment status, health care insurance, median income, use of food stamps, and urban\/rural classification.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe utilization of remote monitoring by patients was assessed weekly with \u003Ca href=\u0022http:\/\/Merlin.net\u0022\u003Ehttp:\/\/Merlin.net\u003C\/a\u003E. Adherence was defined as the number of total follow-up weeks that included a status transmission. Remote monitoring adherence was categorized as high (\u226575%), low (between 0% and 75%), and none. The primary end point of interest was all-cause mortality.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EA larger proportion of patients with high utilization of remote monitoring survived when compared to patients with low utilization of remote monitoring (HR, 1.53; 95% CI, 1.47 to 1.59; p\u0026lt;0.001) or no utilization of remote monitoring (HR, 2.40; 95% CI, 2.32 to 2.49; p\u0026lt;0.001; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). In addition, patients with low adherence to remote monitoring were more likely to survive than patients who did not utilize remote monitoring (HR, 1.56; 95% CI, 1.51 to 1.61; p\u0026lt;0.001). Remote monitoring adherence was associated with increased survival regardless of device type.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/9\/16.2\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Proportion of Surviving Patients According to RM Adherence\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-531374387\u0022 data-figure-caption=\u0022Proportion of Surviving Patients According to RM Adherence\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/9\/16.2\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/9\/16.2\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/9\/16.2\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15886\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EProportion of Surviving Patients According to RM Adherence\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003ERM=remote monitoring.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from S Mittal, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003EIn the United States, adherence rates were highest in the Midwest, South (excluding Florida), and the Pacific Northwest. In contrast, the lowest adherence rates appeared to be in the Northeast, the Chicago area, southern Florida, and California. Socioeconomic factors, such as unemployment, lack of health care insurance, use of food stamps, earnings below the poverty line, education level, and having a telephone, were not associated with adherence to remote monitoring.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EIn conclusion, Dr. Mittal stated that the data from this study showed that adherence to remote monitoring is associated with improved survival, irrespective of the type of implanted device. He highlighted that patients with high adherence to remote monitoring were associated with improved survival rates when compared with patients with either low or no adherence to remote monitoring. Dr. Mittal indicated that the results of this study suggest that adherence to remote monitoring is important.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/9\/16.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzp6g1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzp6g1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}