Comparative assessment of cardiac arrhythmias and clinical and economic analysis using remote telemetry in elderly and senile patients following dual-chamber pacemaker implantation

Aim. To compare the frequency and timing of cardiac arrhythmia detection and conduct a clinical and economic analysis of remote telemetry (RT) in elderly and senile patients following dual-chamber pacemaker (PM) implantation compared to in-person clinical follow-up over a 12-month period.

Methods. A prospective study was conducted involving 92 patients (50% female), with a mean age of 71,5 years. The intervention group (n=39) was monitored remotely using the Medtronic CareLink Network, USA, with patients transmitting data monthly for one year. The control group (n=53) underwent in-person clinical follow-ups at one month and one year post-implantation. The groups were comparable in age, sex, clinical diagnoses, and complications (p>0,05). A cost-effectiveness analysis (CEA) was performed, and the cost-effectiveness ratio (CER) was calculated.

Results. No statistically significant differences were observed between the experimental and control groups in the frequency of cardiac arrhythmias. However, significant differences were found in the timing of arrhythmia detection (p<0,001), with earlier detection in the experimental group. According to the results of the clinical and economic costeffectiveness analysis, the CER value for the remote monitoring method (33226,30 [33226,30; 33226,30]) is statistically significantly lower than the similar coefficient for in-person diagnostics (373542,00 [3735,42; 373542,00]).

Conclusion. The use of RT in elderly and senile patients following dual-chamber PM implantation did not show a statistical difference in arrhythmia detection rates. However, cardiac arrhythmias were diagnosed earlier in the experi­ mental group. The cost-effectiveness analysis demonstrated that RT requires lower financial costs to achieve a unit of effectiveness compared to in-person monitoring.

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