The prevalence of implantable cardioverter-defibrillator (ICD) and heart failure patients eligible for remote monitoring in Germany

• Published in: BMC cardiovascular disorders Vol. 24; no. 1; pp. 572 - 8
• Main Authors: Schwab, Jörg Otto, Gricar, Boye, Hauser, Tino
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17.10.2024; BioMed Central; BMC
• Subjects: Aged; Cardiovascular diseases; Congestive heart failure; Defibrillators; Defibrillators, Implantable; Electric Countershock - adverse effects; Electric Countershock - instrumentation; Female; Germany - epidemiology; Health aspects; Heart failure; Heart Failure - diagnosis; Heart Failure - epidemiology; Heart Failure - physiopathology; Heart Failure - therapy; Humans; Implantable Cardioverter-Defibrillator; Implantable cardioverter-defibrillators; Implantation rate; Infrastructure; Male; Methods; Middle Aged; Mortality; Patient monitoring; Patient Selection; Patients; Population studies; Predictive Value of Tests; Prevalence; Prevalence model; Prevention; Quality assurance; Quality control; Reimbursement; Remote monitoring; Remote Sensing Technology; Risk factors; Sensitivity analysis; Time Factors; Transplants & implants; Ventricular Function, Left; Germany; Heart failure; Implantable Cardioverter-Defibrillator; Prevalence model; Infrastructure; Strategy; Implantation rate; Remote monitoring
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-024-04245-8

In Germany, contemporary data on the prevalence of patients with an implantable cardioverter-defibrillator (ICD) is lacking. Recently, ICD patients with heart failure (HF) fulfilling pre-defined criteria by the G-BA (Federal Joined Committee) are eligible for remote monitoring (RM) reimbursement. This investigation aims to evaluate the prevalence of HF patients with an ICD meeting these criteria. Annual national quality assurance data from all German hospitals on newly implanted ICDs, New York Heart Association (NYHA) class and left ventricular ejection fraction (LVEF) between 2010 and 2021 were obtained to build a prevalence model. The number of ICD patients eligible for RM was calculated by applying the main G-BA inclusion criteria. The ICD prevalence increased continuously from 2010 to 2017 (202.637 patients in 2017) and decreased with a lower rate until 2022. The model calculated an ICD prevalence of 190.698 patients in 2022 of which an estimated 120.941 ICD patients with HF were eligible for RM. This reflects approximately 63% of the actual total estimated ICD patient population in Germany. The model identified a large patient population currently eligible for RM. To our knowledge, this is the first study providing information on the size of this ICD patient population with HF in Germany. With only a fraction of eligible patients currently receiving RM, these findings may facilitate future planning, resource calculations and scale-up of RM. The building of a specific infrastructure focussing on efficient use of resources reflects a mandatory prerequisite for successful RM implementation.