Remote Follow-Up of Implantable Cardioverter Defibrillators

2013 ◽  
pp. 162-172
Author(s):  
David L. Scher ◽  
Franco Naccarella ◽  
Zhang Feng ◽  
Giovanni Rinaldi
Keyword(s):  
Remote Monitoring ◽  
Clinical Information ◽  
Medical Industry ◽  
Implantable Cardioverter Defibrillators ◽  
Remote Monitoring System ◽  
Patients With Heart Failure ◽  
New Literature ◽  
Cardioverter Defibrillators ◽  
Monitoring Devices

In this chapter, the authors introduce some concepts about the remote follow-up of Implantable Cardioverter Defibrillators (ICD). Even if this type of remote monitoring system is relatively new, literature has demonstrated the utilization in clinical practice and during the last few years, the medical industry has provided different devices. Starting from the background, some models of utilizations are presented, focusing on the description of the main functions provided by some devices offered on the market. Next the motivations for which remote follow-up is needed are explored; a better management of the patient is described in several studies, and the integration of clinical information from monitoring devices in Electronic Medical Records is presented as the important step in order to provide comprehensive clinical information about the patient. Also, economic issues are shown. Then, some experiences realized in U.S. are explored, and at last, a number of questions are proposed to the discussion as contribution to the next research. Some Italian recent experiences in the field of remote monitoring and home care of patients with heart failure with and without implantable devices are reported.

scholarly journals Remote Monitoring with Appropriate Reaction to Alerts Was Associated with Improved Outcomes in Chronic Heart Failure: Results from the OptiLink HF Study

2020 ◽  
Author(s):  
Jan Wintrich ◽  
Valérie Pavlicek ◽  
Johannes Brachmann ◽  
Ralph Bosch ◽  
Christian Butter ◽  
...  
Keyword(s):  
Heart Failure ◽  
Remote Monitoring ◽  
Cardiovascular Death ◽  
Medical Intervention ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiac Decompensation ◽  
Clinical Events ◽  
Improved Outcomes ◽  
Cardioverter Defibrillators

Background - Impedance-based remote monitoring (RM) failed to reduce clinical events in the OptiLink HF trial. However, rates of alert-driven interventions triggered by intrathoracic fluid index threshold crossings (FTC) were low indicating physicians' inappropriate reactions to alerts. Methods - We separated appropriate from inappropriate contacts to FTC transmissions in the OptiLink HF trial. Appropriate contacts had to meet the following criteria: i) initial telephone contact within 2 working days after FTC transmission, ii) follow-up contacts according to study protocol, and iii) medical intervention initiated after FTC due to cardiac decompensation. We compared time to cardiovascular death or heart failure hospitalization between RM patients contacted appropriately or inappropriately and patients with usual care (UC). Results - In the RM group, at least one FTC alert was transmitted in 356 patients (70.5%; n=505). Of note, only 55.5% (n=758) of all transmitted FTCs (n=1365) were followed by an appropriate contact. While 113 patients (31.7%; n=356) have been contacted appropriately after every FTC, in 243 patients (68.3%; n=356) at least one FTC was not responded by an appropriate contact. Compared to UC, RM with appropriate contacts to FTC alerts independently reduced the risk of the primary endpoint (Hazard ratio, 0.61; 95% confidence interval 0.39-0.95; p=0.027). Conclusions - RM appropriate reactions to FTC alerts are associated with significantly improved clinical outcomes in patients with advanced HF and implantable cardioverter-defibrillators.

Assessment of a remote monitoring system for implantable cardioverter defibrillators

2008 ◽  
Vol 14 (6) ◽  
pp. 290-294 ◽  
Author(s):  
Cristina Masella ◽  
Paolo Zanaboni ◽  
Francesca Di Stasi ◽  
Serena Gilardi ◽  
Patrizia Ponzi ◽  
...  
Keyword(s):  
Monitoring System ◽  
Remote Monitoring ◽  
Implantable Cardioverter Defibrillators ◽  
Remote Monitoring System ◽  
Cardioverter Defibrillators

scholarly journals Remote monitoring of implantable cardioverter defibrillators: Patient experiences and preferences for follow‐up

2019 ◽  
Vol 42 (2) ◽  
pp. 120-129 ◽  
Author(s):  
Ivy Timmermans ◽  
Mathias Meine ◽  
Istvan Szendey ◽  
Johannes Aring ◽  
Javier Romero Roldán ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Patient Experiences ◽  
Implantable Cardioverter Defibrillators ◽  
Cardioverter Defibrillators

scholarly journals Cyborg Heart

2013 ◽  
Vol 26 (2) ◽  
pp. 14-28 ◽  
Author(s):  
Pernille Bjørn ◽  
Randi Markussen
Keyword(s):  
Sense Of Community ◽  
Remote Monitoring ◽  
Patient Empowerment ◽  
Home Monitoring ◽  
The Body ◽  
Implantable Cardioverter Defibrillators ◽  
Understanding Of Science ◽  
Cardioverter Defibrillators ◽  
Monitoring Devices ◽  
Analytical Device

We argue that a cyborg approach both emphasizes the complexity in treating patients with implantable cardioverter defibrillators (ICDs) attached to home monitoring devices, and makes it possible to decipher modern perspectives in the notion of ‘Patient 2.0’ and other representations of patients. We attempt to open up the notion of Patient 2.0 exemplified by ICD patients by drawing on the cyborg idea as developed by Donna Haraway as well as her understanding of science and the body as an apparatus of bodily production. We include the feminists Rosi Braidotti, Anne Balsamo, Geoff Bowker, and Leigh Star in discussing the cyborg, its infrastructures and affective potentials. We analyse modern imaginaries of remote monitoring as they are portrayed on the websites of the two largest manufacturers of ICD technologies, and based on an analysis of the apparatus of bodily production involved when patients visit a hospital to have their illness monitored we propose the analytical device cyborg heart to capture an affective apparatus of bodily production in the clinic and the idea of an enlarged sense of community as opposed to modern imaginaries of patient empowerment. Finally we discuss how the device cyborg heart differs from the notion logic of care.

scholarly journals Impact of Moderate to Severe Renal Impairment on Mortality and Appropriate Shocks in Patients with Implantable Cardioverter Defibrillators

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Venkata M. Alla ◽  
Kishlay Anand ◽  
Mandeep Hundal ◽  
Aimin Chen ◽  
Showri Karnam ◽  
...  
Keyword(s):  
Linear Models ◽  
Severe Renal Impairment ◽  
Medical Center ◽  
Implantable Cardioverter Defibrillators ◽  
Free Survival ◽  
Kaplan Meier ◽  
Appropriate Shocks ◽  
The Impact ◽  
Cardioverter Defibrillators

Background. Due to underrepresentation of patients with chronic kidney disease (CKD) in large Implantable-Cardioverter Defibrillator (ICD) clinical trials, the impact of ICD remains uncertain in this population.Methods. Consecutive patients who received ICD at Creighton university medical center between years 2000–2004 were included in a retrospective cohort after excluding those on maintenance dialysis. Based on baseline Glomerular filtration rate (GFR), patients were classified as severe CKD: GFR < 30 mL/min; moderate CKD: GFR: 30–59 mL/min; and mild or no CKD: GFR ≥ 60 mL/min. The impact of GFR on appropriate shocks and survival was assessed using Kaplan-Meier method and Generalized Linear Models (GLM) with log-link function.Results. There were 509 patients with a mean follow-up of 3.0 + 1.3 years. Mortality risk was inversely proportional to the estimated GFR: 2 fold higher risk with GFR between 30–59 mL/min and 5 fold higher risk with GFR < 30 mL/min. One hundred and seventy-seven patients received appropriate shock(s); appropriate shock-free survival was lower in patients with severe CKD (GFR < 30) compared to mild or no CKD group (2.8 versus 4.2 yrs).Conclusion. Even moderate renal dysfunction increases all cause mortality in CKD patients with ICD. Severe but not moderate CKD is an independent predictor for time to first appropriate shock.

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