Effectiveness of remote monitoring of cardiac implantable electronic devices in detection and treatment of clinical and device-related cardiovascular events in daily practice: the HomeGuide Registry

Follow-up of patients with cardiac implantable electronic devices is challenging due to the increasing number and technical complexity of devices coupled to increasing clinical complexity of patients. Remote monitoring (RM) offers the opportunity to optimise clinic workflow and to improve device monitoring and patient management. Several randomised clinical trials and registries have demonstrated that RM may reduce number of hospital visits, time required for patient follow-up, physician and nurse time, hospital and social costs. Furthermore, patient retention and adherence to follow-up schedule are significantly improved by RM. Continuous wireless monitoring of data stored in the device memory with automatic alerts allows early detection of device malfunctions and of events requiring clinical reaction, such as atrial fibrillation, ventricular arrhythmias and heart failure. Early reaction may improve patient outcome. RM is easy to use and patients showed a high level of acceptance and satisfaction. Implementing RM in daily practice may require changes in clinic workflow. To this purpose, new organisational models have been introduced. In spite of a favourable cost:benefit ratio, RM reimbursement still represents an issue in several European countries.

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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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