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Remote follow-up of ICD patients reduces costs

Remote monitoring significantly reduces the cost of follow-up in patients with implantable defibrillators (ICDs), according to new data from the French, ECOST (Effectiveness and Cost of ICD Follow-Up Schedule with Telecardiology) study.1

Over a 27-month follow-up period, ambulatory costs were significantly reduced, while hospital costs were not significantly different, the study found. Adding ICD costs to ambulatory costs, the savings generated by a home monitoring system (Biotronik Home Monitoring®) amounted to €315 per patient per year, including the cost of the remote monitoring service.

ECOST was a prospective multicenter clinical trial designed to examine the safety and efficacy of remote monitoring of ICD patients with. The study analysed 433 patients from 43 sites throughout France who were randomly assigned to remote monitoring follow-up or standard in-office care. The 221 remote monitoring patients were seen in the ambulatory department once a year, unless remote monitoring reported a technical or clinical event requiring an in-office visit. The 212 control group patients underwent in-office visits every six months.

Costs were calculated using the French National Health Insurance fund’s actual billings, and consider hospital costs for the management of cardiovascular disorders and ambulatory costs including costs related to device management and other ambulatory costs. By reducing shocks, remote monitoring had a positive impact on battery life, meaning devices needed to be replaced less frequently, the study showed. The cost savings shown in the 27-month study are expected to increase over time.

Biotronik Home Monitoring® system

Biotronik Home Monitoring® system

The economic analysis of the ECOST study did not take into account physician fees for remote monitoring, as they are not yet reimbursed by the French National Health Insurance system. French authorities are currently negotiating how to reimburse physicians for remote follow-ups.


1. Guédon-Moreau L, Kouakam C, Klug D, et al. Decreased delivery of inappropriate shocks achieved by remote monitoring of ICD: a sub study of the ECOST trial. J Cardiovasc Electrophysiol 2014.

Published on: March 28, 2014

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  • ArrhythmiaAlliance
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