Background:The effect of remote monitoring (RM) in atrial arrhythmia detection, stroke reduction, and anticoagulation therapy remains unknown, particularly for patients with implantable or wearable cardiac devices.

Methods and Results:We performed a systematic review and meta-analysis to evaluate the role of RM in atrial arrhythmia detection, stroke reduction and anticoagulation therapeutic intervention. Online databases were queried to include randomized controlled trials comparing detection of atrial arrhythmia and stroke risk between patients undergoing RM and those receiving in-office (IO) follow-up. Outcomes and complications of RM-guided anticoagulation therapy and conventional therapy in patients with atrial fibrillation were also reviewed. A total of 16 studies were included. Compared with patients receiving IO follow-up, patients undergoing RM had a significantly higher detection rate of atrial arrhythmia (risk ratio [RR], 1.363; 95% confidence interval [CI], 1.147–1.619), and a lower risk of stroke (RR, 0.539; 95% CI, 0.301–0.936). The higher rate of atrial arrhythmia was only noted in patients with wearable devices (RR, 4.070; 95% CI, 2.408–6.877), and the lower risk of stroke was only noted in patients with cardiovascular implantable electronic devices (CIED) (RR, 0.513; 95% CI, 0.265–0.996).

Conclusions:RM is effective for atrial arrhythmia detection in patients using wearable devices and for reducing the risk of stroke in patients with CIED.

背景：远程监测 (RM) 在房性心律失常检测、卒中减少和抗凝治疗中的作用仍然未知，尤其是对于植入式或可穿戴式心脏装置的患者。

方法和结果：我们进行了系统回顾和荟萃分析，以评估 RM 在房性心律失常检测、减少卒中和抗凝治疗干预中的作用。在线数据库被查询以包括比较接受 RM 和接受办公室 (IO) 随访的患者之间的房性心律失常和中风风险的检测的随机对照试验。还回顾了 RM 指导的抗凝治疗和常规治疗在房颤患者中的结果和并发症。共纳入 16 项研究。与接受 IO 随访的患者相比，接受 RM 的患者的房性心律失常检出率显着更高（风险比 [RR]，1.363；95% 置信区间 [CI]，1.147-1.619），并且卒中风险更低（ RR，0.539；95% CI，0.301–0.936）。

结论： RM 对于使用可穿戴设备的患者的房性心律失常检测和降低 CIED 患者中风的风险是有效的。