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

Published online by Cambridge University Press:  02 September 2019

Georgia Spentzou ,
Kaitlin Mayne ,
Helen Fulton  and
Karen McLeod Open the ORCID record for Karen McLeod [Opens in a new window]
Georgia Spentzou*
Affiliation:
Department of Paediatric Cardiology, Royal Hospital for Children, Queen Elizabeth University Hospitals, Glasgow, Lanarkshire G51 4TF, UK
Kaitlin Mayne
Affiliation:
Department of Paediatric Cardiology, Royal Hospital for Children, Queen Elizabeth University Hospitals, Glasgow, Lanarkshire G51 4TF, UK
Helen Fulton
Affiliation:
Department of Paediatric Cardiology, Royal Hospital for Children, Queen Elizabeth University Hospitals, Glasgow, Lanarkshire G51 4TF, UK
Karen McLeod
Affiliation:
Department of Paediatric Cardiology, Royal Hospital for Children, Queen Elizabeth University Hospitals, Glasgow, Lanarkshire G51 4TF, UK
*
Author for correspondence: G. Spentzou, Department of Paediatric Cardiology, Royal Hospital for Children, Queen Elizabeth University Hospitals, Road, Glasgow G51 4TF, UK. Tel: +44 141 451 6508; Fax: +44 141 201 2215; E-mail: [email protected]
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Abstract

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.

Keywords

virtual clinicsremote monitoringpacemakersdefibrillatorschildren
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 10 , October 2019 , pp. 1243 - 1247
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Copyright
© Cambridge University Press 2019 

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References

Isherwood, J, Hillman, T, Goddard, A. Royal College of Physicians. Outpatients: The Future – Adding Value Through Sustainability. RCP, London, 2018.Google Scholar
Richards, T. Bring outpatients into the 21st century. BMJ 2018; 361: k2472.CrossRefGoogle ScholarPubMed
Burri, H, Senouf, D. Remote monitoring and follow-up of pacemakers and implantable cardioverter defibrillators. Europace 2009; 11: 701–709.CrossRefGoogle ScholarPubMed
de Cock, CC, Elders, J, van Hemel, NM, et al. Remote monitoring and follow-up of cardiovascular implantable electronic devices in the Netherlands: an expert consensus report of the Netherlands Society of Cardiology. Neth Heart J 2012; 20: 53–65.CrossRefGoogle ScholarPubMed
Varma, N, Epstein, A, Irimpen, A, Schweikert, R, Love, C, TRUST Investigators. Efficacy and safety of automatic remote monitoring for implantable cardioverter-defibrillator follow-up. Circulation 2010; 122: 325–332.CrossRefGoogle ScholarPubMed
Crossley, G, Boyle, A, Vitense, H, Chang, Y, Mead, RH. The CON-NECT (Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision) trial: the value of wireless remote monitoring with automatic clinician alerts. J Am Coll Cardiol 2011; 57: 1181–1189. 2010; 3: 428–436.CrossRefGoogle Scholar
Calò, L, Gargaro, A, DeRuvo, E, et al. Economic impact of remote monitoring on ordinary follow-up of implantable cardioverter defibrillators as compared with conventional in-hospital visits: a single-center prospective and randomized study. J Interv Card Electrophysiol 2013; 37: 69–78.CrossRefGoogle ScholarPubMed
Mabo, P, Victor, F, Bazin, P, et al. A randomized trial of long-term remote monitoring of pacemaker recipients. Eur Heart J 2012; 33: 1105–1111.CrossRefGoogle ScholarPubMed
Mittal, S, Piccini, JP, Snell, J, Prillinger, JB, Dalal, N, Varma, N. Improved survival in patients enrolled promptly into remote monitoring following cardiac implantable electronic device implantation. J Interv Card Electrophysiol 2016; 46: 129–136.CrossRefGoogle ScholarPubMed
Varma, N, Piettro Ricci, R. Impact of remote monitoring on clinical outcome. J Cardiovasc Electrophysiol 2015; 26: 1388–1395.CrossRefGoogle Scholar
Czosek, RJ, Meganathan, K, Anderson, JB, Knilans, TK, Marino, BS, Heaton, PC. Cardiac rhythm devices in the pediatric population: utilization and complications. Heart Rhythm 2012; 9: 199–208.CrossRefGoogle ScholarPubMed
Silvetti, MS, Saputo, FA, Palmieri, R, et al. Results of remote follow-up and monitoring in young patients with cardiac implantable electronic devices. Cardiol Young 2016; 26: 53–60.CrossRefGoogle ScholarPubMed
Leoni, L, Padalino, M, Biffanti, R, et al. Pacemaker remote monitoring in the pediatric population: is it a real solution? Pacing Clin Electrophysiol 2015; 38: 565–571.CrossRefGoogle ScholarPubMed
Maloy, L, Gingerich, J, Olson, M, Atkins, D. Remote monitoring of cardiovascular implantable devices in the pediatric population improves detection of adverse events. Pediatr Cardiol 2014; 35: 301–306.CrossRefGoogle Scholar
Kam, R. Automatic capture verification in pacemakers (AutoCapture) – utility and problems. Indian Pacing Electrophysiol J 2004; 4: 73–78.Google ScholarPubMed
Benezet-Mazuecos, J, Iglesias, JA, Rubio, JM, et al. Limitations of the AutoCapture™ Pacing System in patients with cardiac stimulation devices. Europace 2014; 16: 1469–1475.CrossRefGoogle ScholarPubMed