Scientific article
Open access

Smartphone-based cardiac implantable electronic device remote monitoring : improved compliance and connectivity

Published inEuropean heart journal. Digital health, vol. 4, no. 1, p. 43-52
Publication date2023-01-01
First online date2022-11-11


Remote monitoring (RM) is the standard of care for follow up of patients with cardiac implantable electronic devices. The aim of this study was to compare smartphone-based RM (SM-RM) using patient applications (myMerlinPulse™ app) with traditional bedside monitor RM (BM-RM).

Methods and results

The retrospective study included de-identified US patients who received either SM-RM or BM-RM capable of implantable cardioverter defibrillators or cardiac resynchronization therapy defibrillators (Abbott, USA). Patients in SM-RM and BM-RM groups were propensity-score matched on age and gender, device type, implant year, and month. Compliance with RM was quantified as the proportion of patients enrolling in the RM system (Merlin.net™) and transmitting data at least once. Connectivity was measured by the median number of days between consecutive transmissions per patient. Of the initial 9714 patients with SM-RM and 26 679 patients with BM-RM, 9397 patients from each group were matched. Remote monitoring compliance was higher in SM-RM; significantly more patients with SM-RM were enrolled in RM compared with BM-RM (94.4 vs. 85.0%, P < 0.001), similar number of patients in the SM-RM group paired their device (95.1 vs. 95.0%, P = 0.77), but more SM-RM patients transmitted at least once (98.1 vs. 94.3%, P < 0.001). Connectivity was significantly higher in the SM-RM, with patients transmitting data every 1.2 (1.1, 1.7) vs. every 1.7 (1.5, 2.0) days with BM-RM (P < 0.001) and remained better over time. Significantly more SM-RM patients utilized patient-initiated transmissions compared with BM-RM (55.6 vs. 28.1%, P < 0.001).


In this large real-world study, patients with SM-RM demonstrated improved compliance and connectivity compared with BM-RM.

  • Bluetooth
  • Cardiac implantable electronic devices
  • Compliance
  • Connectivity
  • Patient-initiated transmissions
  • Radio frequency
Citation (ISO format)
MANYAM, Harish et al. Smartphone-based cardiac implantable electronic device remote monitoring : improved compliance and connectivity. In: European heart journal. Digital health, 2023, vol. 4, n° 1, p. 43–52. doi: 10.1093/ehjdh/ztac071
Main files (1)
Article (Published version)
ISSN of the journal2634-3916

Technical informations

Creation10/19/2023 2:18:56 PM
First validation02/28/2024 9:18:11 AM
Update time02/28/2024 9:18:11 AM
Status update02/28/2024 9:18:11 AM
Last indexation05/06/2024 6:02:29 PM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack