Remote monitoring and mortality outcomes in heart failure patients with cardiac implantable devices in an ultra-peripheral region
M Camara Farinha, I Barroso Almeida, I Coutinho Dos Santos, V Pereira Ferreira, F Duarte, A Monteiro, M PachecoAbstract
Background
Delivering specialised heart failure (HF) care in geographically remote island regions is challenging due to limited access to in-person follow-up and specialised services. Although remote monitoring of cardiac implantable electronic devices (CIEDs) could help to overcome these barriers, real-world evidence remains scarce.
Objectives
To evaluate the association between remote monitoring and healthcare utilisation and mortality in HF patients with CIEDs followed in an ultra-peripheral archipelago.
Methods
We conducted a retrospective observational study of HF patients implanted with CIEDs at a single referral centre serving a remote Atlantic island region. Patients were stratified according to the presence of remote monitoring. Outcomes included emergency department visits for HF, HF rehospitalisation, cardiovascular mortality and all-cause mortality.
Results
Of the 236 patients, 132 were monitored remotely. Rates of emergency department visits for HF (22.2% vs 17.7%, p = 0.47) and of HF rehospitalisation (25.8% vs 28.9%, p = 0.63) were similar between groups. Five-year cardiovascular mortality was lower in patients with remote monitoring compared with those without (1.5% vs 6.2%, p = 0.04), as was all-cause mortality (2.3% vs 12.4%, p = 0.005).
Conclusions
In this geographically isolated healthcare setting, patients followed with remote monitoring showed numerically lower all-cause and cardiovascular mortality, while rates of healthcare utilisation were comparable between groups. These findings provide real-world insight into heart failure care delivery in ultra-peripheral regions.