The title of the study: "The clinical evaluation of the remote notification to reduce time to clinical decision (CONNECT) Trial: The value of remote monitoring."
I present a summary of the method and the results of the study gleaned from the slides presented by Dr. Crossley at the conference.
Additionally investigated were rates utilization of the health care system including hospitalization and between treatment groups.
The patients were followed for 12 months. (On first reading, I found the the time relatively short in that I would not expect enough differentiating events would occur during that time. However, on further reading, I believe my first impression was incorrect.)
The median time (used nonparametric inferential statistics for the analysis) from the cardiac or device event to clinical decision was 4.6 days in the remote group and 22 days in the in office group. This difference was significant. The remote group involved 172 patient while the in-office group involved 145 patients.
- Atrial Tachycardia/Fibrillation (AT/AF) for 12 hours or more
- Fast Ventricular rate. Of at least 120 beats per minute during at least a 6 hour AT/AFT event
- At least two shocks delivered in an episode
- Lead impedance out of range
- All therapies in a specific zone were exhausted for an episode
- Ventricular Fibrillation detection/therapy off
- Low battery
The number of office visits per patient reported are shown below.
Number of incidents where patients used the health care system show virtually no difference, hospitalization or emergency room.
The CONNECT and (Biotronik) TRUST studies show clear benefits from a number of standpoints for remote monitoring. In addition, the CONNECT study showed clear cost and hospital resource utilization benefits from remote monitoring in that hospitalized patients had shorter stays indicating that they were in better shape than patients in the in-office group when admitted to the hospital. Quick responses seem to lead to better outcomes as well as cost reductions.