Change in the use of remote monitoring of cardiac implantable electronic devices in Italian clinical practice over a 5-year period

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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Does the CHA 2 DS 2 -VASc score reliably predict atrial arrhythmias? Analysis of a nationwide database of remote monitoring data transmitted daily from cardiac implantable electronic devices

Heart Rhythm ◽

10.1016/j.hrthm.2018.02.023 ◽

2018 ◽

Vol 15 (7) ◽

pp. 971-979 ◽

Cited By ~ 13

Author(s):

Giovanni Rovaris ◽

Francesco Solimene ◽

Antonio D'Onofrio ◽

Gabriele Zanotto ◽

Renato P. Ricci ◽

...

Keyword(s):

Remote Monitoring ◽

Electronic Devices ◽

Monitoring Data ◽

Atrial Arrhythmias ◽

Nationwide Database ◽

Cardiac Implantable Electronic Devices

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Subclinical Atrial Fibrillation and Risk of Stroke: Past, Present and Future

Medicina ◽

10.3390/medicina55100611 ◽

2019 ◽

Vol 55 (10) ◽

pp. 611 ◽

Cited By ~ 3

Author(s):

AlTurki ◽

Marafi ◽

Russo ◽

Proietti ◽

Essebag

Keyword(s):

Atrial Fibrillation ◽

Clinical Practice ◽

Electronic Devices ◽

High Rate ◽

Cardiac Monitoring ◽

Stroke Event ◽

Cardiac Implantable Electronic Devices ◽

Increased Risk ◽

History Of ◽

New Evidence

Subclinical atrial fibrillation (SCAF) describes asymptomatic episodes of atrial fibrillation (AF) that are detected by cardiac implantable electronic devices (CIED). The increased utilization of CIEDs renders our understanding of SCAF important to clinical practice. Furthermore, 20% of AF present initially as a stroke event and prolonged cardiac monitoring of stroke patients is likely to uncover a significant prevalence of SCAF. New evidence has shown that implanting cardiac monitors into patients with no history of atrial fibrillation but with risk factors for stroke will yield an incidence of SCAF approaching 30–40% at around three years. Atrial high rate episodes lasting longer than five minutes are likely to represent SCAF. SCAF has been associated with an increased risk of stroke that is particularly significant when episodes of SCAF are greater than 23 hours in duration. Longer episodes of SCAF are incrementally more likely to progress to episodes of SCAF >23 hours as time progresses. While only around 30–40% of SCAF events are temporally related to stroke events, the presence of SCAF likely represents an important risk marker for stroke. Ongoing trials of anticoagulation in patients with SCAF durations less than 24 hours will inform clinical practice and are highly anticipated. Further studies are needed to clarify the association between SCAF and clinical outcomes as well as the factors that modify this association.

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