Heart-Failure Patients Finicky About Cardiac-Device Remote Feedback

Patrice Wendling

June 14, 2016

NICE, FRANCE — Given their druthers, heart-failure patients are very interested in receiving remote feedback about their cardiac implantable device, but less interested in their clinical status and only vaguely interested in reminders on a healthy lifestyle, new research shows[1].

When asked about their wishes for future improvements in remote monitoring, three-quarters of patients said that receiving data on their smartphone regarding battery status (75%), device integrity (73%), lead integrity (71%), and percent stimulation (69%) was "indispensable."

Most patients (87%) also rated information on ventricular tachycardia and antitachycardia pacing as indispensable, but fewer patients were inclined to do so for feedback on their ECG (32%), atrial fibrillation (68%), or HF (71%), according to a poster presentation at the European Heart Rhythm Association (EHRA) EUROPACE-CARDIOSTIM 2016 meeting.

"I think they want to know clinical information from their physician, not from the device," lead investigator Dr Luca Rossi (Guglielmo Da Saliceto Hospital, Piacenza, Italy) told heartwire from Medscape.

No correlation was found between increased remote information wishes and age or sex, although patients living in the country were slightly less interested in receiving remote feedback than their counterparts in the city.

The results are somewhat surprising given that the average patient age was 69 years and some patients in the mountainous region have to travel an hour or more to reach the hospital for their once- or twice-yearly visits. Further, clinical information delivered via smartphone is tailored to the individual patient.

Dr Luca Rossi

"Maybe people are divided into two kinds of people; some want technology and some refuse technology and want the white coat, want the physician," he said.

Notably, patients expressed the lowest interest regarding healthy lifestyle reminders, with only a third rating information on body weight (32%), fluid intake (35%), and drug reminders (37%) as indispensable or highly desirable.

Rossi suggested that patients may be getting saturated with lifestyle tips from the internet or television and that even those patients who aren't tech-savvy "have a son or daughter who can apply themselves on technology."

A total of 260 patients (73% male) with an implantable cardioverter-defibrillator (mean duration 34 months) for ischemic heart disease or dilated cardiomyopathy filled out the three-part questionnaire, scored using a five-point Likert scale. Questionnaire responses were cross-checked with demographic variables and analyzed using a multiple regression model.

Scores for the external and internal reliability of the questionnaire, assessed using Cronbach's alpha test, were 0.812 and 0.823, respectively.

Dr Rossi reports no relevant financial relationships.

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