Intérêt du télésuivi automatisé des stimulateurs cardiaques

Abstract : Introduction: remote monitoring of cardiac implantable electronic devices is now a part of the US guidelines. Most of the studies proving its benefice are made with implantable cardiac defibrillators and the data concerning pacemakers are scarce. Aims To evaluate the interest of pacemakers remote monitoring in terms of morbidity-mortality and use of health care. Method: this monocentric retrospective study compared two populations of patients implanted of a simple or dual chamber pacemaker in our Center between January 1, 2013 and December 31, 2016. The control group applied a standard in consultation follow-up while the remote monitoring group was systematically followed by remote monitoring. The morbidity-mortality primary endpoint was a combined outcome comprising all-cause mortality, admissions in emergency room and all-cause hospitalizations. The primary endpoint concerning the use of health care was the number of consultations per year and the secondary endpoint included consultations with interrogation of the pacemaker, admissions to the emergency room and hospitalizations. Data were collected from medical records and calls to patients. Results: the remote monitoring group (N = 310) and control group (N = 310) were followed for a median period of 20 months and did not differ in age, sex and indication of implantation. There is no difference regarding the primary endpoint of morbidity-mortality (p = 0, 175), the number of stroke (p = 0, 821) or the introduction of anticoagulants (p = 0, 935). We highlighted a reduction in the number of consultations per year (p < 0.001), consultations with pacemaker interrogation (p < 0.001), of the number of all-cause admissions in emergency rooms (p = 0, 01), and a statically non-significant trend in the reduction of the number of hospitalization (p = 0, 194). Conclusion: in comparison with a standard follow-up, remote monitoring reduces the use of health care without affecting the morbidity-mortality.
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Master Thesis
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Hugo Marchand. Intérêt du télésuivi automatisé des stimulateurs cardiaques. Médecine humaine et pathologie. 2018. ⟨dumas-01977188⟩

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