Telemonitoring of left-ventricular assist device patients—current status and future challenges

Abstract

E-health, especially telemedicine, has undergone a remarkably dynamic development over the past few years. Most experience is currently in the field of telemedical care for heart failure (HF) patients. However, HF patients with an implanted left-ventricular assist device (LVAD) have been more or less excluded from consistent telemonitoring until now. And yet, continual monitoring would be very significant for this patient group because of the complexity of its aftercare, requiring steady control of various parameters (device-related parameters, vital parameters, coagulation parameters, etc.). With timely action, severe and costly complications like pump thromboses and driveline infections could be detected early on or even avoided completely. This paper describes the potential of telemonitoring in LVAD patients, as well as its first clinical implementation according to the available literature. It also describes the requirements for a complete telemonitoring of LVAD patients, facilitating the advancement of this form of continual monitoring to a clinical standard which would increase the quality of aftercare for this very special patient collective enormously.

Improved aftercare in LVAD patients: Development and feasibility of a smartphone application as a first step for telemonitoring

“…Automated data transmission in the future is both conceivable and desirable. The technical requirements for open interfaces are already fulfilled in some state‐of‐the‐art LVAD systems, but have not yet been released for end users . Open interfaces would mean in theory that the pump parameters could be sent to the smartphone and from there to the clinical application continually and automatically.…”

“…The technical requirements for open interfaces are already fulfilled in some state-of-the-art LVAD systems, but have not yet been released for end users. 7 Open interfaces would mean in theory that the pump parameters could be sent to the smartphone and from there to the clinical application continually and automatically. Availability of such live data would have crucial benefits regarding the early accurate detection of LVAD thromboses.…”

“…At the moment, however, telemonitoring approaches have yet to be implemented in the routine aftercare of LVAD patients . A conceivable first and simple step in this direction could be a smartphone application.…”

“…Telemonitoring approaches have the potential to significantly improve such and similar challenges to LVAD aftercare for both patients and physicians. [6][7][8] In our modern digital age, computers provide many different ways of systematically recording, transferring, and evaluating data. As part of LVAD therapy, this could in particular lead to improvements of the following aspects:…”

“…At the moment, however, telemonitoring approaches have yet to be implemented in the routine aftercare of LVAD patients. 7 A conceivable first and simple step in this direction could be a smartphone application. Smartphone applications are now used in all kinds of different areas (also medical), [9][10][11][12] and it may be assumed that this development will continue in the future.…”