Clinical Utility of the TRENDS Remote Monitoring Function Integrated into a Wearable Cardioverter-Defibrillator.

BACKGROUND

Wearable cardioverter-defibrillators (WCDs) are equipped with the TRENDS remote-monitoring system, enabling continuous assessment of arrhythmias, physiological parameters, and patient-reported outcomes. This study evaluated the clinical utility of TRENDS-integrated WCD management and compared it with a historical control.

METHODS

We prospectively analyzed 36 consecutive patients who received a WCD with TRENDS between 2019 and 2024 and compared them with 30 historical controls treated before the implementation of TRENDS.

RESULTS

The WCD indications were heart failure as primary prevention (64%) and acute coronary syndrome with ventricular arrhythmias (28%). Among 18 patients who met the criteria for an implantable cardioverter-defibrillator (ICD), including 1 patient with WCD shock, 9 ultimately underwent ICD implantation. The mean daily WCD wear-time was 21.3 h and did not differ significantly from that of the historical control. The response rate to health-related questionnaires was 89%. TRENDS detected symptom exacerbation in 31% of patients, weight gain in 19% of patients, and missed medication in 19% of patients. Daily step-count was significantly lower in patients with ICD indications than in those without (5012 ± 2980 steps vs. 7977 ± 3584 steps, p = 0.01). TRENDS data also aided in initiating anticoagulation therapy and optimizing beta-blocker therapy.

CONCLUSIONS

TRENDS provided clinically actionable physiologic and patient-reported information that supported individualized cardiovascular management.