EVOLVO Study by Landolina M and colleagues [Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators. The Evolution of Management Strategies of Heart Failure Patients With Implantable Defibrillators (EVOLVO) Study. Circulation. 2012; 125: 2985-2992] have found that remote monitoring of defibrillators is useful in terms of reducing emergency room visits, total health care usage and better quality of care. The study involved 200 patients with implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy with defibrillator (CRT-D) with wireless monitoring capability. The monitoring device could interrogate and transmit the data over a standard telephone line. This would occur at scheduled intervals without patient intervention and also alert based transmissions. Though patient clinical status as measured by Clinical Composite Score was similar in the control group and the remote monitoring group, the quality of life (QOL) as assessed by Minnesota Living With Heart Failure Questionnaire was better in the remote monitoring group with a P value of 0.026. Emergent / urgent visits for heart failure, arrhythmias or ICD related events were thirty five percent lower in the remote monitoring arm. Even total health care visits were lower by 21 percent, meaning that though the number of elective visits are increased by remote monitoring, the total visits are kept low. 86 percent of the extra visits necessitated by remote monitoring were deemed necessary for the clinical management.
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