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.