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

Silvetti, Massimo Stefano; Saputo, Fabio Anselmo; Palmieri, Rosalinda; Placidi, Silvia; Santucci, Lorenzo; Mambro, Corrado Di; Righi, Daniela; Drago, Fabrizio

doi:10.1017/s1047951114002613

Cited by 6 publications

(9 citation statements)

References 29 publications

(72 reference statements)

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“…After implantation, clinical evaluation was performed at 1 month and then every 6 months. Automatic transmissions were sent daily via telemetry and revised off‐line by our group, as previously reported . In case of symptoms, additional transmissions were performed manually by patients and revised by physicians.…”

Section: Methodsmentioning

confidence: 99%

Miniaturized Implantable Loop Recorder in Small Patients: An Effective Approach to the Evaluation of Subjects at Risk of Sudden Death

Placidi

Drago

Milioni

et al. 2016

Pacing Clinical Electrophis

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Section: Methodsmentioning

confidence: 99%

Miniaturized Implantable Loop Recorder in Small Patients: An Effective Approach to the Evaluation of Subjects at Risk of Sudden Death

Placidi

Drago

Milioni

et al. 2016

Pacing Clinical Electrophis

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“…It is probable that this relevant result is due to the high-rate limit programming for VF and the recent technical improvements in manufacturing the devices: new systems (S-ICD) and new algorithms (such as the "smart pass" ™ in S-ICD) may reduce complications. Moreover, the new remote monitoring devices may lead to an early diagnosis of malfunctions and complications [23]. Complications occurred earlier than effective therapies.…”

Section: Discussionmentioning

confidence: 99%

ICD Outcome in Pediatric Cardiomyopathies

Silvetti

Tamburri

Campisi

et al. 2022

JCDD

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Background: Pediatric patients with cardiomyopathies are at risk of malignant arrhythmias and sudden cardiac death (SCD). An ICD may prevent SCD. The aim of this study was to evaluate ICD implantation outcomes, and to compare transvenous and subcutaneous ICDs (S-ICDs) implanted in pediatric patients with cardiomyopathies. Methods: The study is single center and retrospective, and includes pediatric patients with cardiomyopathies who required ICD implantation (2010–2021). Outcomes were recorded for appropriate/inappropriate ICD therapy and surgical complications. Transvenous ICD and S-ICD were compared. Data are presented as median values (25th–75th centiles). Results: Forty-four patients with cardiomyopathies (hypertrophic 39%, arrhythmogenic 32%, dilated 27%, and restrictive 2%) underwent transvenous (52%) and S-ICD (48%) implantation at 14 (12–17) years of age, mostly for primary prevention (73%). The follow-up period was 29 (14–60) months. Appropriate ICD therapies were delivered in 25% of patients, without defibrillation failures. Lower age at implantation and secondary prevention were significant risk factors for malignant ventricular arrhythmias that required appropriate ICD therapies. ICD-related complications were surgical complications (18%) and inappropriate shocks (7%). No significant differences in outcomes were recorded, either when comparing transvenous and S-ICD or comparing the different cardiomyopathies. Conclusions: In pediatric patients with cardiomyopathy, ICD therapy is effective, with a low rate of inappropriate shocks. Neither ICD type (transvenous and S-ICDs) nor the cardiomyopathies subgroup revealed divergent outcomes.

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“…11 Two published studies on the remote follow-up of cardiac devices in children suggest remote monitoring can help to detect complications earlier, potentially improving clinical outcomes. [12][13][14] In these studies, downloads were arranged at fixed three-monthly intervals or were patient-triggered and the majority reviewed by a pacing technician alone. However, not all patients need to have downloads as frequently as three-monthly, especially if set up for devicetriggered automatic alerts.…”

Section: Discussionmentioning

confidence: 99%

Virtual clinics for follow-up of pacemakers and implantable cardioverter defibrillators in children

et al. 2019

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There is growing interest in the use of digital medicine to reduce the need for traditional outpatient follow-up. Remote interrogation of pacemakers and implantable cardioverter defibrillators is now possible with most devices. The aim of our study was to evaluate the safety and efficacy of virtual pacing clinics in following up children with pacemakers and implantable cardioverter defibrillators, including epicardial systems.Methods:The study was retrospective over 8 years (2010–2017), with review of patient records and analysis of downloads from the implantable cardiac devices to the virtual clinics.Results:A total of 75 patients were set up for virtual clinic follow-up during the study period, 94.5% with a pacemaker and 5.5% an implantable cardioverter defibrillator. The majority (76.8%) had an epicardial system. Data on lead impedance, battery longevity, programmed parameters, detected arrhythmias, percentage pacing and delivered defibrillator therapies were obtainable by download. Lead threshold measurements were obtainable via download in 83.7% of the devices, including epicardial systems. No concerning device issue was missed. In 15% of patients a major issue was detected remotely, including three patients with lead fractures. The virtual clinics resulted in fewer hospital attendances while enhancing monitoring and enabling more frequent device checks. The vast majority (91.4%) of families who responded to a questionnaire were satisfied with the virtual clinic follow-up.Conclusions:Virtual clinics allow safe and effective follow-up of children with pacemakers and implantable cardioverter defibrillators, including those with epicardial systems and are associated with high levels of parent satisfaction.

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

Abstract: Remote 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.

Cited by 6 publications

References 29 publications

Miniaturized Implantable Loop Recorder in Small Patients: An Effective Approach to the Evaluation of Subjects at Risk of Sudden Death

Miniaturized Implantable Loop Recorder in Small Patients: An Effective Approach to the Evaluation of Subjects at Risk of Sudden Death

ICD Outcome in Pediatric Cardiomyopathies

Virtual clinics for follow-up of pacemakers and implantable cardioverter defibrillators in children

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