Role of remote monitoring in detection of atrial arrhythmia, stroke reduction, and use of anticoagulation therapy - A systematic review and meta-analysis

Jia Pei Jang, Hui Ting Lin, Yu Jen Chen, Ming Hsiung Hsieh, Yu Chen Huang

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: The effect of remote monitoring (RM) in atrial arrhythmia detection, stroke reduction, and anticoagulation therapy remains unknown, particularly for patients with implantable or wearable cardiac devices. Methods and Results: We performed a systematic review and meta-analysis to evaluate the role of RM in atrial arrhythmia detection, stroke reduction and anticoagulation therapeutic intervention. Online databases were queried to include randomized controlled trials comparing detection of atrial arrhythmia and stroke risk between patients undergoing RM and those receiving in-office (IO) follow-up. Outcomes and complications of RM-guided anticoagulation therapy and conventional therapy in patients with atrial fibrillation were also reviewed. A total of 16 studies were included. Compared with patients receiving IO follow-up, patients undergoing RM had a significantly higher detection rate of atrial arrhythmia (risk ratio [RR], 1.363; 95% confidence interval [CI], 1.147–1.619), and a lower risk of stroke (RR, 0.539; 95% CI, 0.301–0.936). The higher rate of atrial arrhythmia was only noted in patients with wearable devices (RR, 4.070; 95% CI, 2.408–6.877), and the lower risk of stroke was only noted in patients with cardiovascular implantable electronic devices (CIED) (RR, 0.513; 95% CI, 0.265–0.996). Conclusions: RM is effective for atrial arrhythmia detection in patients using wearable devices and for reducing the risk of stroke in patients with CIED.

Original languageEnglish
Pages (from-to)1922-1930
Number of pages9
JournalCirculation Journal
Volume84
Issue number11
DOIs
Publication statusPublished - Oct 23 2020

Keywords

  • Anticoagulation
  • Atrial fibrillation
  • Cardiovascular implantable electronic devices
  • Remote monitoring
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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