Abstract
BACKGROUND: Cardiac implantable electronic devices (CIEDs) are crucial in managing various cardiac conditions, but their monitoring poses considerable challenges. Algorithm-enabled remote monitoring of these devices has emerged as a promising solution to enhance patient outcomes and potentially reduce health care expenditures; however, its economic impact remains underexplored. OBJECTIVE: This systematic review protocol aims to review and synthesize the existing evidence on the cost-effectiveness and cost-utility of algorithm-enabled remote monitoring for CIEDs in patients with or at risk of heart failure. METHODS: The search of literature will be performed in MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library, with supplementary searches in the National Health Service Economic Evaluation Database, the National Institute for Health and Care Excellence, the Canadian Agency for Drugs and Technologies in Health, the International Network of Agencies for Health Technology Assessment, and the National Institute for Health and Care Research. This protocol is reported in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols) 2015 statement, and the completed review will be reported following the PRISMA 2020 statement. RESULTS: Following database searching and deduplication, 3108 records were retrieved; 731 (23.5%) duplicates were removed, leaving 2377 (76.5%) records for title and abstract screening. The review will identify and synthesize economic evaluations of algorithm-enabled remote monitoring in adults with CIEDs, summarizing reported costs, outcomes, and cost-effectiveness results. Methodological quality, risk of bias, and sources of heterogeneity across studies will be assessed. CONCLUSIONS: The findings of this review may help inform health care providers, policymakers, and other stakeholders by clarifying the current economic evidence on these monitoring systems, informing adoption decisions, and identifying areas requiring further research.