Putting down the phone: the obsolescence of transtelephonic monitoring for pacemaker follow-up

Purpose: The evolution of heart rhythm monitoring technology over the past few decades has seen a decline in the use and need of transtelephonic monitoring (TTM). We sought to establish a predicted date for the sun setting of TTM at our institution, as well as establish the current demographics of the patients still using this technology. Methods: We retrospectively reviewed all patients with permanent pacemakers receiving routine device follow-up at our institution (Mayo Clinic—Rochester) between 2015 and 2018. From this cohort, we reviewed and analyzed patients using TTM for device follow-up and utilized projected battery longevity to determine cessation date. Pacemaker implantation date, underlying arrhythmia, and most recent device interrogation reports were also collected. Results: As of March 2018, a total of 3543 patients with permanent pacemakers were being followed at our institution and 289 (8.2%) are using TTM for monitoring device function (147 male, mean age 79.9 ± 12.0 years). Of those currently using TTM, by January of 2020, only 122 (42.2%) are predicted to be using this technology for device follow-up, 40 (13.8%) by January 2022, with zero patients by November of 2024. Conclusions: The use of TTM will continue to significantly diminish over the next few years. Based on battery longevity estimates, we predict that by the end of 2024 TTM will no longer be used for device follow-up at our institution.