Abstract 15225: Remote Monitoring Using Implantable Cardiac Defibrillators for Heart Failure Management in a European Cohort: A Meta-analysis

Introduction: Remote monitoring (RM) using implantable cardiac defibrillators (ICD) is a rapidly emerging alternative modality in heart failure management. Studies involving US cohorts have shown promising results with RM. We aim to perform a meta-analysis assessing the clinical outcomes of RM versus conventional follow-up among heart failure (HF) patients with an ICD in a European cohort. Methods: Electronic database and reference list searches were conducted to identify European studies assessing patient outcomes when managed with RM using ICD versus conventional follow up. After a review of abstracts and selected full-text articles, we identified four randomized trials (RCT) for inclusion. Quality was assessed using the Cochrane Risk of Bias Tool. The primary outcome was the incidence of HF hospitalization and the secondary outcome was all-cause mortality during the follow-up period. A random-effects model was used. All analysis was performed using Cochrane Revman version 5.3. Results: Four RCT’s were included, with a total of 4504 participants. Mean follow-up time was 22 months. Rate of HF hospitalization with RM was 678 versus 680 with conventional management (RR: 0.98, 95% CI: 0.88 to 1.10, p = 0.75). All-cause mortality with RM was 252 versus 284 with conventional management (RR: 0.88, 95% CI: 0.75 to 1.03, p =0.11). Conclusions: Our study found that in a European cohort, there was no difference in the incidence of HF hospitalization or all-cause mortality among patients managed with RM using ICD and those managed with conventional care. Further research is required to assess the feasibility and generalizability of HF management using ICD’s in different patient populations.