基于智能手机的心脏植入式电子设备远程监测：提高依从性与连通性。
Smartphone-based cardiac implantable electronic device remote monitoring: improved compliance and connectivity.
作者信息
Manyam Harish, Burri Haran, Casado-Arroyo Ruben, Varma Niraj, Lennerz Carsten, Klug Didier, Carr-White Gerald, Kolli Kranthi, Reyes Ignacio, Nabutovsky Yelena, Boriani Giuseppe
机构信息
Department of Cardiovascular Medicine, University of Tennessee College of Medicine Chattanooga, 979 East Third Street, Suite C-520, Chattanooga, TN 37403, USA.
Heart and Lung Institute, Erlanger Health System, 975 E. 3rd St., Suite C520, Chattanooga, TN 37403, USA.
出版信息
Eur Heart J Digit Health. 2022 Nov 11;4(1):43-52. doi: 10.1093/ehjdh/ztac071. eCollection 2023 Jan.
AIMS
Remote monitoring (RM) is the standard of care for follow up of patients with cardiac implantable electronic devices. The aim of this study was to compare smartphone-based RM (SM-RM) using patient applications (myMerlinPulse™ app) with traditional bedside monitor RM (BM-RM).
METHODS AND RESULTS
The retrospective study included de-identified US patients who received either SM-RM or BM-RM capable of implantable cardioverter defibrillators or cardiac resynchronization therapy defibrillators (Abbott, USA). Patients in SM-RM and BM-RM groups were propensity-score matched on age and gender, device type, implant year, and month. Compliance with RM was quantified as the proportion of patients enrolling in the RM system (Merlin.net™) and transmitting data at least once. Connectivity was measured by the median number of days between consecutive transmissions per patient. Of the initial 9714 patients with SM-RM and 26 679 patients with BM-RM, 9397 patients from each group were matched. Remote monitoring compliance was higher in SM-RM; significantly more patients with SM-RM were enrolled in RM compared with BM-RM (94.4 vs. 85.0%, < 0.001), similar number of patients in the SM-RM group paired their device (95.1 vs. 95.0%, = 0.77), but more SM-RM patients transmitted at least once (98.1 vs. 94.3%, < 0.001). Connectivity was significantly higher in the SM-RM, with patients transmitting data every 1.2 (1.1, 1.7) vs. every 1.7 (1.5, 2.0) days with BM-RM ( < 0.001) and remained better over time. Significantly more SM-RM patients utilized patient-initiated transmissions compared with BM-RM (55.6 vs. 28.1%, < 0.001).
CONCLUSION
In this large real-world study, patients with SM-RM demonstrated improved compliance and connectivity compared with BM-RM.
目的
远程监测（RM）是心脏植入式电子设备患者随访的护理标准。本研究的目的是比较使用患者应用程序（myMerlinPulse™应用程序）的基于智能手机的RM（SM-RM）与传统床边监测RM（BM-RM）。
方法与结果
这项回顾性研究纳入了美国未识别身份的患者，这些患者接受了能够植入式心脏复律除颤器或心脏再同步治疗除颤器（美国雅培公司）的SM-RM或BM-RM。SM-RM组和BM-RM组的患者在年龄、性别、设备类型、植入年份和月份方面进行了倾向得分匹配。将RM的依从性量化为注册RM系统（Merlin.net™）并至少传输一次数据的患者比例。通过每位患者连续传输之间的天数中位数来衡量连接性。在最初的9714例SM-RM患者和26679例BM-RM患者中，每组9397例患者进行了匹配。SM-RM的远程监测依从性更高；与BM-RM相比，SM-RM注册RM的患者明显更多（94.4%对85.0%，<0.001），SM-RM组配对设备的患者数量相似（95.1%对95.0%，=0.77），但SM-RM组中至少传输一次数据的患者更多（98.1%对94.3%，<0.001）。SM-RM的连接性明显更高，患者每1.2（1.1，1.7）天传输一次数据，而BM-RM为每1.7（1.5，2.0）天（<0.001），并且随着时间的推移保持更好。与BM-RM相比，SM-RM患者中使用患者发起传输的数据明显更多（55.6%对28.1%，<0.001）。
结论
在这项大型现实世界研究中，与BM-RM相比，SM-RM患者的依从性和连接性得到了改善。
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