Remote monitoring of implantable cardiac devices

Ganeshan, Raj; Enriquez, Alan D.; Freeman, James V.

doi:10.1097/hco.0000000000000471

Cited by 24 publications

(19 citation statements)

References 42 publications

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“…This could possibly be explained by the fact that these patients, often suffering from dyspnea, value visiting physicians who review both their heart and lungs in order to get better insights in their symptoms. However, the general tendency of patients with comorbidities preferring regular follow‐up underlines the importance to investigate the integration of other devices with CIED hardware to allow for monitoring of comorbid conditions and a complete assessment of patient status . We did not observe associations between patient preferences and cardiac‐related clinical outcomes (ie, hospital consultations, emergency room visits, hospital admissions, and ICD shocks).…”

Section: Discussionmentioning

confidence: 73%

“…However, the general tendency of patients with comorbidities preferring regular follow-up underlines the importance to investigate the integration of other devices with CIED hardware to allow for monitoring of comorbid conditions and a complete assessment of patient status. 39 We did not 18 where 84% of the patients wanted to receive more information about transmissions, and 21% wished for a faster reply.…”

Section: Discussionmentioning

confidence: 99%

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

Timmermans

Meine

Szendey

et al. 2019

Pacing Clinical Electrophis

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BackgroundPatient satisfaction with remote patient monitoring (RPM) of implantable cardioverter defibrillators (ICDs) seems to be high, yet knowledge on long‐term patient experiences is limited. The European REMOTE‐CIED study explored patients' experiences with RPM, examined patient's preferences for ICD follow‐up, and identified determinants of patient's preferences in the first 2 years postimplantation.MethodsEuropean heart failure patients (N = 300; median age = 66 years [interquartile range (IQR) = 59‐73], and 22% female) with a first‐time ICD received a Boston Scientific LATITUDE RPM system (Marlborough, MA, USA) and had scheduled in‐clinic follow‐ups once a year. Patients completed questionnaires at 1‐2 weeks and also at 3, 6, 12, and 24 months postimplantation and clinical data were obtained from their medical records. Patient evaluation data were analyzed descriptively, and Student's t‐tests/Man‐Whitney U tests or Chi‐square tests/Fisher's exact tests were performed to examine determinants of patient preferences.ResultsAt 2 years postimplantation, the median patient satisfaction score with the RPM system was 9 out of 10 (IQR = 8‐10), despite 53% of the patients experiencing issues (eg, failure to transmit data). Of the 221 patients who reported their follow‐up preferences, 43% preferred RPM and 19% preferred in‐clinic follow‐up. Patients with a preference for RPM were more likely to be higher educated (P = 0.04), employed (P = 0.04), and equipped with a new LATITUDE model (P = 0.04), but less likely to suffer from chronic obstructive pulmonary disease (P = 0.009).ConclusionIn general, patients were highly satisfied with RPM, but a subgroup preferred in‐clinic follow‐up. Therefore, physicians should include patients’ concerns and preferences in the decision‐making process, to tailor device follow‐up to individual patients’ needs and preferences.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

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

Timmermans

Meine

Szendey

et al. 2019

Pacing Clinical Electrophis

View full text Add to dashboard Cite

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“…The next step is to test the impact of these interventions on a larger scale to evaluate targeted outcomes and the resulting implications for patient self-care and the clinical management of patients living with CIEDs. Despite the substantial benefits of remote monitoring, patient participation and adherence remain low [15]. Thus, to realize the full potential of the sophisticated engineering in CIEDs, we need to understand a way to meaningfully engage patients, and we believe this can be done by presenting meaningful data to patients as feedback from remote monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, to realize the full potential of the sophisticated engineering in CIEDs, we need to understand a way to meaningfully engage patients, and we believe this can be done by presenting meaningful data to patients as feedback from remote monitoring. The authors of a recent review of CIED use offer helpful suggestions that may lead to improved engagement including standardizing transmission data, increasing the frequency of comprehensive information, and using predictive algorithms with the data as a means to prevent worsening conditions [15].…”

Section: Discussionmentioning

confidence: 99%

Data Integration and Interoperability for Patient-Centered Remote Monitoring of Cardiovascular Implantable Electronic Devices

2019

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The prevalence of cardiovascular implantable electronic devices with remote monitoring capabilities continues to grow, resulting in increased volume and complexity of biomedical data. These data can provide diagnostic information for timely intervention and maintenance of implanted devices, improving quality of care. Current remote monitoring procedures do not utilize device diagnostics to their potential, due to the lack of interoperability and data integration among proprietary systems and electronic medical record platforms. However, the development of a technical framework that standardizes the data and improves interoperability shows promise for improving remote monitoring. Along with encouraging the implementation of this framework, we challenge the current paradigm and propose leveraging the framework to provide patients with their remote monitoring data. Patient-centered remote monitoring may empower patients and improve collaboration and care with health care providers. In this paper, we describe the implementation of technology to deliver remote monitoring data to patients in two recent studies. Our body of work explains the potential for developing a patent-facing information display that affords the meaningful use of implantable device data and enhances interactions with providers. This paradigm shift in remote monitoring—empowering the patient with data—is critical to using the vast amount of complex and clinically relevant biomedical data captured and transmitted by implantable devices to full potential.

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“…In particular, for people in rural areas, in patients with impaired mobility or mental status, RM offers the chance for improved safety and quality of life. So far, remote control has not been fully implemented in the follow-up of ICD patients in Northern America and Europe, though [7].…”

Section: Introductionmentioning

confidence: 99%

105 Inappropriate ICD Shocks in a Patient with Dilated Cardiomyopathy and Broca’s Aphasia

Georgi¹,

Neuß²,

Möller³

et al. 2019

Case Reports in Cardiology

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With a growing number of ICD recipients, device complications are seen more frequently in the clinical setting and outpatient departments. Among the most severe are ICD infections and inappropriate therapies caused by oversensing of atrial tachycardias or lead fracture. We report on a 76-year-old female patient with dilative cardiomyopathy and Broca’s aphasia after stroke, who experienced 105 consecutive inappropriate ICD shocks due to cluster missensing of her fractured ICD lead. The diagnosis was complicated and delayed by patient’s aphasia emphasizing the need for intensified remote monitoring along with regular in-person visits, especially in people with intellectual or communication disabilities.

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Remote monitoring of implantable cardiac devices

Cited by 24 publications

References 42 publications

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

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

Data Integration and Interoperability for Patient-Centered Remote Monitoring of Cardiovascular Implantable Electronic Devices

105 Inappropriate ICD Shocks in a Patient with Dilated Cardiomyopathy and Broca’s Aphasia

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