281 Home delivery of the communicator for remote monitoring of cardiac implantable devices: a multicentre experience during the COVID-19 lockdown

Abstract Aims During the COVID-19 pandemic in-person visits for patients with cardiac implantable electronic devices should be replaced by remote monitoring (RM), in order to prevent viral transmission. A direct home-delivery service of the RM communicator has been implemented at 49 Italian arrhythmia centres. Methods and results According to individual patient preference or the organizational decision of the centre, patients were assigned to the home-delivery group or the standard in-clinic delivery group. In the former case, patients received telephone training on the activation process and use of the communicator. In June 2020, the centres were asked to reply to an ad hoc questionnaire to describe and evaluate their experience in the previous 3 months. RM was activated in 1324 patients: 821 (62%) received the communicator at home and the communicator was activated remotely. Activation required one additional call in 49% of cases, and the median time needed to complete the activation process was 15 min (25th–75th percentile: 10–20). 753 (92%) patients were able to complete the correct activation of the system. At the time when the questionnaire was completed, 743 (90%) communicators were regularly transmitting data. The service was generally deemed useful (96% of respondents) in facilitating the activation of RM during the COVID-19 pandemic and possibly beyond. Conclusions Home delivery of the communicator proved to be a successful approach to system activation, and received positive feedback from clinicians. The increased use of a RM protocol will reduce risks for both providers and patients, while maintaining high-quality care.

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USE OF AUTOMATED SOFTWARE TO INCREASE PATIENT COMPLIANCE AND TRANSMISSION CAPTURE IN THE REMOTE MONITORING OF CARDIAC IMPLANTABLE ELECTRONIC DEVICES (CIEDS)

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(20)31158-x ◽

2020 ◽

Vol 75 (11) ◽

pp. 531

Author(s):

Kevin R. Campbell ◽

Dhanunjaya R. Lakkireddy ◽

Rakesh Gopinathannair

Keyword(s):

Patient Compliance ◽

Remote Monitoring ◽

Electronic Devices ◽

Cardiac Implantable Electronic Devices ◽

Automated Software

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Canadian Registry of Electronic Device Outcomes: remote monitoring outcomes in the Abbott battery performance alert—a multicentre cohort

EP Europace ◽

10.1093/europace/euab025 ◽

2021 ◽

Author(s):

Sharath Kumar ◽

Jason Davis ◽

Bernard Thibault ◽

Iqwal Mangat ◽

Benoit Coutu ◽

...

Keyword(s):

Remote Monitoring ◽

Primary Outcome ◽

Electronic Device ◽

Electronic Devices ◽

Cardiac Resynchronization ◽

Device Performance ◽

Cardiac Implantable Electronic Devices ◽

All Cause Mortality ◽

Multicentre Cohort

Abstract Aims Cardiac implantable electronic devices with device advisories have the potential of device malfunction. Remote monitoring (RM) of devices has been suggested to allow the identification of abnormal device performance and permit early intervention. We sought to describe the outcomes of patients with and without RM in devices subject to the Abbott Premature Battery Depletion (PBD) advisory with data from a Canadian registry. Methods and results Patients with an Abbott device subject to the PBD advisory from nine implantable cardioverter defibrillator (ICD) implanting centres in Canada were included in the registry. The use of RM was identified from baseline and follow-up data in the registry. The primary outcome was detection of PBD and all-cause mortality. A total of 2666 patients were identified with a device subject to the advisory. In all, 1687 patients (63.2%) had RM at baseline. There were 487 deaths during follow-up. At a mean follow-up of 5.7 ± 0.7 years, mortality was higher in those without a remote monitor compared with RM at baseline (24.7% vs. 14.5%; P < 0.001). Pre-mature battery depletion was identified in 36 patients (2.1%) with RM vs. 7 (0.7%) without RM (P = 0.004). Time to battery replacement was significantly reduced in patients on RM (median 5 vs. 13 days, P = 0.001). Conclusion The use of RM in patients with ICD and cardiac resynchronization therapy under advisory improved detection of PBD, time to device replacement, and was associated with a reduction in all-cause mortality. The factors influencing the association with mortality are unknown and deserve further study.

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Follow-Up of Cardiac Implantable Electronic Devices—Remote Monitoring and in Person

Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy ◽

10.1016/b978-0-323-37804-8.00040-7 ◽

2017 ◽

pp. 1133-1157

Author(s):

Niraj Varma ◽

Renato Pietro Ricci

Keyword(s):

Remote Monitoring ◽

Electronic Devices ◽

Cardiac Implantable Electronic Devices

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Challenges in remote monitoring of cardiac implantable electronic devices in 2021

Kardiologia Polska ◽

10.33963/kp.15899 ◽

2021 ◽

Author(s):

Giovanni Malanchini ◽

Gabriele Ferrari ◽

Cristina Leidi ◽

Paola Ferrari ◽

Michele Senni ◽

...

Keyword(s):

Remote Monitoring ◽

Electronic Devices ◽

Cardiac Implantable Electronic Devices

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Results of remote follow-up and monitoring in young patients with cardiac implantable electronic devices

Cardiology in the Young ◽

10.1017/s1047951114002613 ◽

2015 ◽

Vol 26 (1) ◽

pp. 53-60 ◽

Cited By ~ 2

Author(s):

Massimo S. Silvetti ◽

Fabio A. Saputo ◽

Rosalinda Palmieri ◽

Silvia Placidi ◽

Lorenzo Santucci ◽

...

Keyword(s):

Remote Monitoring ◽

Heart Defects ◽

Electronic Devices ◽

Young Patients ◽

Implantable Cardioverter Defibrillators ◽

Wireless Devices ◽

Cardiac Implantable Electronic Devices ◽

System Inclusion ◽

To Receive

AbstractBackgroundRemote monitoring is increasingly used in the follow-up of patients with cardiac implantable electronic devices. Data on paediatric populations are still lacking. The aim of our study was to follow-up young patients both in-hospital and remotely to enhance device surveillance.MethodsThis is an observational registry collecting data on consecutive patients followed-up with the CareLink system. Inclusion criteria were a Medtronic device implanted and patient’s willingness to receive CareLink. Patients were stratified according to age and presence of congenital/structural heart defects (CHD).ResultsA total of 221 patients with a device – 200 pacemakers, 19 implantable cardioverter defibrillators, and two loop recorders – were enrolled (median age of 17 years, range 1–40); 58% of patients were younger than 18 years of age and 73% had CHD. During a follow-up of 12 months (range 4–18), 1361 transmissions (8.9% unscheduled) were reviewed by technicians. Time for review was 6±2 minutes (mean±standard deviation). Missed transmissions were 10.1%. Events were documented in 45% of transmissions, with 2.7% yellow alerts and 0.6% red alerts sent by wireless devices. No significant differences were found in transmission results according to age or presence of CHD. Physicians reviewed 6.3% of transmissions, 29 patients were contacted by phone, and 12 patients underwent unscheduled in-hospital visits. The event recognition with remote monitoring occurred 76 days (range 16–150) earlier than the next scheduled in-office follow-up.ConclusionsRemote follow-up/monitoring with the CareLink system is useful to enhance device surveillance in young patients. The majority of events were not clinically relevant, and the remaining led to timely management of problems.

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