scholarly journals Remote monitoring versus conventional follow-up for implantable cardiac devices: Rationale and design of the PORTLink (PORTuguese Research on Telemonitoring with CareLink) trial

2013 ◽  
Vol 32 (12) ◽  
pp. 957-964
Author(s):  
Mário Oliveira ◽  
Milene Fernandes ◽  
João Primo ◽  
Hipólito Reis ◽  
Paulo Nicola
Keyword(s):  
Remote Monitoring ◽  
Cardiac Devices ◽  
Implantable Cardiac Devices

Automatic Remote Monitoring of Implantable Cardiac Devices in Clinical Practice – The Lumos-T Safely Reduces Routine Office Device Follow-up (TRUST) Trial

2010 ◽  
Vol 6 (3) ◽  
pp. 87
Author(s):  
Niraj Varma ◽  
Keyword(s):  
Clinical Practice ◽  
Remote Monitoring ◽  
Home Monitoring ◽  
Implantable Devices ◽  
Cardiac Device ◽  
Cardiac Devices ◽  
Enhance Patient Safety ◽  
Implantable Cardiac Devices ◽  
Post Implantation

The use of implantable electronic cardiac devices is increasing. Post-implantation follow-up is important for monitoring both device function and patient condition; however, clinical practice is inconsistent. For example, implantable cardioverter–defibrillator follow-up schedules vary from every three months to yearly according to facility and physician preference and the availability of resources. Importantly, no surveillance occurs between follow-up visits. By contrast, implantable devices with automatic remote monitoring capability provide a means for performing constant surveillance, with the ability to identify salient problems rapidly. The Lumos-T Reduces Routine Office Device Follow-up Study (TRUST) demonstrated that remote home monitoring reduced clinic burden and allowed early detection of patient and/or system problems, enabling efficient monitoring and an opportunity to enhance patient safety. The results of the trial have significant implications for the management of patients receiving all forms of implantable electronic cardiac device.

Virtual clinics for follow-up of pacemakers and implantable cardioverter defibrillators in children

2019 ◽  
Vol 29 (10) ◽  
pp. 1243-1247
Author(s):  
Georgia Spentzou ◽  
Kaitlin Mayne ◽  
Helen Fulton ◽  
Karen McLeod
Keyword(s):  
Parent Satisfaction ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiac Devices ◽  
Digital Medicine ◽  
Implantable Cardiac Devices ◽  
System Data ◽  
Set Up ◽  
Cardioverter Defibrillators ◽  
Virtual Clinic

AbstractThere is growing interest in the use of digital medicine to reduce the need for traditional outpatient follow-up. Remote interrogation of pacemakers and implantable cardioverter defibrillators is now possible with most devices. The aim of our study was to evaluate the safety and efficacy of virtual pacing clinics in following up children with pacemakers and implantable cardioverter defibrillators, including epicardial systems.Methods:The study was retrospective over 8 years (2010–2017), with review of patient records and analysis of downloads from the implantable cardiac devices to the virtual clinics.Results:A total of 75 patients were set up for virtual clinic follow-up during the study period, 94.5% with a pacemaker and 5.5% an implantable cardioverter defibrillator. The majority (76.8%) had an epicardial system. Data on lead impedance, battery longevity, programmed parameters, detected arrhythmias, percentage pacing and delivered defibrillator therapies were obtainable by download. Lead threshold measurements were obtainable via download in 83.7% of the devices, including epicardial systems. No concerning device issue was missed. In 15% of patients a major issue was detected remotely, including three patients with lead fractures. The virtual clinics resulted in fewer hospital attendances while enhancing monitoring and enabling more frequent device checks. The vast majority (91.4%) of families who responded to a questionnaire were satisfied with the virtual clinic follow-up.Conclusions:Virtual clinics allow safe and effective follow-up of children with pacemakers and implantable cardioverter defibrillators, including those with epicardial systems and are associated with high levels of parent satisfaction.

Abstract 17325: Initial False Positive Episodes and Outcomes of Programming Changes With a Novel Implantable Loop Recorder

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Ethan Hacker ◽  
Tawseef Dar ◽  
Bharath Yarlagadda ◽  
Valay Parikh ◽  
Brandon Wise ◽  
...  
Keyword(s):  
False Positive ◽  
Early Experience ◽  
The Novel ◽  
Implantable Loop Recorder ◽  
Loop Recorder ◽  
Positive Events ◽  
Cardiac Devices ◽  
Implantable Cardiac Devices ◽  
Implantable Loop Recorders

Introduction: Management of voluminous data from implantable cardiac devices is resource intensive. False positive events can be especially problematic with implantable loop recorders (ILRs). We sought to describe our early experience with a novel ILR. Hypothesis: Sensitivity adjustment to <=0.10 mV may reduce false positive ILR detection of bradycardia/pauses. Methods: A single center retrospective study was performed in patients with the Abbott Confirm RX ILR. Tachycardia, atrial fibrillation (AF), bradycardia, and pause events were reviewed to determine whether they were true or false positives. Results: The study included 13 patients (age 67 ±15.8 years, 62% men). The reasons for implant included: AF (n=7, 54%), syncope(n=3, 23%), palpitations (n=2, 15%), and stroke (n=1, 8%). The median follow-up duration was 3.1 months (IQR 1.3-4.4 months). There was no change in serial R waves during mean follow-up of 0.58 months (pre 0.62±0.22 mV, post 0.63±0.22 mV, p=0.52). Tachycardia detection occurred in 6 patients (46%), with only 1 patient having a false positive episode. AF detection occurred in 8 patients (62%), with only 2 patients having true AF episodes. Pause/bradycardia episodes were detected in 5 patients (39%), with false positive episodes in 4 patients. There was no difference in R waves at implant among patients with and without false positive bradycardia/pauses episodes (0.66 ±0.27 vs. 0.44 ± 0.28 mV, p=0.21). The max sensitivity was higher among patients with than without false positive bradycardia/pause episodes (0.14 ±0.01, 0.07 ±0.02 mV, p<0.0001). No patients programmed to sensitivity <=0.10 mV had false positive bradycardia/pause episodes. The sensitivity was adjusted to <=0.10 mV in 3 of 4 patients with false positive bradycardia/pause episodes which eliminated future false positive episodes and did not result in false positive tachycardia/AF episodes. The overall mean monthly rate of false positive bradycardia/pause events was reduced from 387 events/month to zero in these patients. Conclusion: Programming the novel ILR to a sensitivity of <=0.10 mV resulted in a marked reduction in false positive bradycardia/pause episodes without an increase in false positive tachycardia/AF episodes.

Health Care Utilization and Expenditures Associated With Remote Monitoring in Patients With Implantable Cardiac Devices

2016 ◽  
Vol 117 (9) ◽  
pp. 1455-1462 ◽  
Author(s):  
Joseph A. Ladapo ◽  
Mintu P. Turakhia ◽  
Michael P. Ryan ◽  
Sarah A. Mollenkopf ◽  
Matthew R. Reynolds
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Remote Monitoring ◽  
Care Utilization ◽  
Cardiac Devices ◽  
Implantable Cardiac Devices

P994Does AF always beget AF? Retrospective study in patients with complex cardiac devices

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Briosa E Gala ◽  
M Pope ◽  
M Leo ◽  
T R Betts
Keyword(s):  
Retrospective Study ◽  
Remote Monitoring ◽  
Binary Classification ◽  
Statistical Significance ◽  
First Episode ◽  
Cardiac Devices ◽  
Direct Current Cardioversion ◽  
Number Of Patients ◽  
The Mean

Abstract Introduction Atrial fibrillation (AF) is conventionally divided in paroxysmal AF (PAF) and persistent AF (PersAF) according to episode duration, with a perceived inevitable progression of the arrhythmia in most patients: "AF begets AF". This dichotomous classification of AF is currently being challenged by continuous monitoring with implantable cardiac monitors and pacemakers which suggest different patterns of AF with considerable variation in AF burden.  Purpose This study sought to examine the long-term progression of AF burden in patients with complex cardiac devices (implantable cardiac defibrillators [ICD] and cardiac resynchronisation therapy-defibrillators [CRT-D]). Methods This retrospective study examined the weekly AF burden in patients with ICDs and CRT-Ds and on remote monitoring between January 2010 and July 2019.  All transmissions and electrograms were assessed for the presence of AF lasting more than 6 minutes.  The first episode of AF determined was considered follow-up year 0.  PersAF was defined as a weekly AF burden of 100%. Medical records were reviewed for baseline characteristics at the time of the first episode of AF and interventions that may affect burden such as direct current cardioversion (DCCV) and catheter ablations. Results Of 331 patients on remote monitoring, 106 (32%) had evidence of AF. Of these, 89% were male, age 64 ± 12 years, BMI 30 ± 6 kg/m2, LA diameter 4.5 ± 0.8 cm, 58% had an ICD, 10% had previous AF ablation and 27% had antiarrhythmic medication. Forty-six (43%) had PersAF and 60 (57%) had PAF over a total follow-up of 393 patient years (mean follow-up 4.6. ±2.1).  The mean AF burden  was 1.2 ± 4.4% in PAF and 66.4 ± 35.3% in PersAF at the end of the first year of follow-up. When compared to year 1, the mean annual AF burden did not increase in the PAF and PersAF groups. Moreover, the PersAF patients had a significant reduction in the mean annual AF burden up to year 7 of follow-up. In year 8, the mean annual AF burden remained below year 1; however, due to a low number of patients (5) it did not reach statistical significance (mean difference 15.1%, p = 0.06) . To further assess individual progression in PersAF patients, the annual AF burden was subdivided in 4 categories (&lt;25%, 25%-50%, 50%-75% and &gt;75%). In 30 (65%) patients it remained unchanged, in 5(11%) it worsened and in 11 (24%) it improved (Figure ). Moreover, 35 (76%) patients reverted to sinus rhythm following their first episode of PersAF (5 following DCCV and 2 after catheter ablation).  Conclusions In this cohort,  the mean AF burden did not increase; in fact, we observed a significant reduction in patients with PersAF despite a low rate of interventions. These findings reinforce the emerging concept of AF as a heterogenous disease with various phenotypes that challenge the current simplistic binary classification. Abstract Figure

Imaging for electrophysiological procedures

2021 ◽  
pp. 303-314
Author(s):  
Louisa O’Neill ◽  
Iain Sim ◽  
John Whitaker ◽  
Steven Williams ◽  
Henry Chubb ◽  
...  
Keyword(s):  
Sudden Death ◽  
Rapid Development ◽  
Imaging Modalities ◽  
Cardiac Resynchronization ◽  
Cardiac Devices ◽  
Electrophysiological Procedures ◽  
Implantable Cardiac Devices ◽  
Sudden Death Prevention

Electrophysiology is one of the most rapidly growing area of cardiology. Currently >50,000 catheter ablations are performed in Europe every year and >200,000 patients receive a device for arrhythmia treatment, sudden death prevention, or cardiac resynchronization. The advantages and limitations of fluoroscopy are well known. The rapid development of implantable cardiac devices therapies and ablation procedures all depend on accurate and reliable imaging modalities for preprocedural assessments, intraprocedural guidance, detection of complications, and post-procedural assessment for the longitudinal follow-up of patients. Therefore, over the last decades, imaging become an integral part of electrophysiological procedures.

Remote monitoring of implantable cardiac devices

2018 ◽  
Vol 33 (1) ◽  
pp. 20-30 ◽  
Author(s):  
Raj Ganeshan ◽  
Alan D. Enriquez ◽  
James V. Freeman
Keyword(s):  
Remote Monitoring ◽  
Cardiac Devices ◽  
Implantable Cardiac Devices
Sign in / Sign up

Export Citation Format

Share Document