Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-24T09:10:02.649Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  14 January 2015

Massimo S. Silvetti ,
Fabio A. Saputo ,
Rosalinda Palmieri ,
Silvia Placidi ,
Lorenzo Santucci ,
Corrado Di Mambro ,
Daniela Righi  and
Fabrizio Drago
Massimo S. Silvetti*
Affiliation:
Arrhythmia Unit and Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Rome, Italy
Fabio A. Saputo
Affiliation:
Arrhythmia Unit and Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Rome, Italy
Rosalinda Palmieri
Affiliation:
Arrhythmia Unit and Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Rome, Italy
Silvia Placidi
Affiliation:
Arrhythmia Unit and Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Rome, Italy
Lorenzo Santucci
Affiliation:
Arrhythmia Unit and Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Rome, Italy
Corrado Di Mambro
Affiliation:
Arrhythmia Unit and Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Rome, Italy
Daniela Righi
Affiliation:
Arrhythmia Unit and Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Rome, Italy
Fabrizio Drago
Affiliation:
Arrhythmia Unit and Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Rome, Italy
*
Correspondence to: Dr M. S. Silvetti, Arrhythmia Unit and Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Via Torre di Palidoro snc, Fiumicino, 00050 Rome, Italy. Tel: 00390668593354; Fax: 00390668593375; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Remote monitoring is increasingly used in the follow-up of patients with cardiac implantable electronic devices. Data on paediatric populations are still lacking. The aim of our study was to follow-up young patients both in-hospital and remotely to enhance device surveillance.

Methods

This is an observational registry collecting data on consecutive patients followed-up with the CareLink system. Inclusion criteria were a Medtronic device implanted and patient’s willingness to receive CareLink. Patients were stratified according to age and presence of congenital/structural heart defects (CHD).

Results

A total of 221 patients with a device – 200 pacemakers, 19 implantable cardioverter defibrillators, and two loop recorders – were enrolled (median age of 17 years, range 1–40); 58% of patients were younger than 18 years of age and 73% had CHD. During a follow-up of 12 months (range 4–18), 1361 transmissions (8.9% unscheduled) were reviewed by technicians. Time for review was 6±2 minutes (mean±standard deviation). Missed transmissions were 10.1%. Events were documented in 45% of transmissions, with 2.7% yellow alerts and 0.6% red alerts sent by wireless devices. No significant differences were found in transmission results according to age or presence of CHD. Physicians reviewed 6.3% of transmissions, 29 patients were contacted by phone, and 12 patients underwent unscheduled in-hospital visits. The event recognition with remote monitoring occurred 76 days (range 16–150) earlier than the next scheduled in-office follow-up.

Conclusions

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.

Keywords

Pacemakerchildrenimplantable cardiac deviceimplantable cardioverter defibrillatortrans-telephonic monitoringpacing complication
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 1 , January 2016 , pp. 53 - 60
Check for updates
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Silvetti, MS, Drago, F, Grutter, G, De Santis, A, Di Ciommo, V, Ravà, L. Twenty years of paediatric cardiac pacing: 515 pacemakers and 480 leads implanted in 292 patients. Europace 2006; 8: 530–536.CrossRefGoogle ScholarPubMed
2. Silvetti, MS, Drago, F, Di Carlo, D, Placidi, S, Brancaccio, G, Carotti, A. Cardiac pacing in paediatric patients with congenital heart defects: transvenous or epicardial? Europace 2013; 15: 1280–1286.Google Scholar
3. Crossley, GH, Chen, J, Choucair, W, et al. Clinical benefits of remote versus transtelephonic monitoring of implanted pacemakers. J Am Coll Cardiol 2009; 54: 2012–2019.CrossRefGoogle ScholarPubMed
4. Mabo, P, Victor, F, Bazin, P, et al. A randomized trial of long-term remote monitoring of pacemaker recipients (the COMPAS trial). Eur Heart J 2012; 33: 1105–1111.Google Scholar
5. Varma, N, Epstein, AE, Irimpen, A, Schweikert, R, Love, C; TRUST Investigators. Efficacy and safety of automatic remote monitoring for implantable cardioverter-defibrillator follow-up: the Lumos-t Safely Reduces Routine Office Device Follow-up (TRUST) Trial. Circulation 2010; 122: 325–332.CrossRefGoogle ScholarPubMed
6. Crossley, GH, Boyle, A, Vitense, H, Chang, Y, Mead, RH; CONNECT Investigators. The CONNECT (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.CrossRefGoogle ScholarPubMed
7. Lunati, M, Gasparini, M, Santini, M, et al. Follow-up of CRT-ICD: implications for the use of remote follow-up systems. Data from the Insync ICD Italian Registry. Pacing Clin Electrophysiol 2008; 31: 38–46.Google Scholar
8. Marzegalli, M, Lunati, M, Landolina, M, et al. Remote monitoring of CRT-ICD: the multicenter Italian CareLink evaluation – ease of use, acceptance, and organizational implications. Pacing Clin Electrophysiol 2008; 31: 1259–1264.Google Scholar
9. Santini, M, Ricci, RP, Lunati, M, et al. Remote monitoring of patients with biventricular defibrillators through the CareLink system improves clinical management of arrhythmias and heart failure episodes. J Interv Card Electrophysiol 2009; 24: 53–61.CrossRefGoogle ScholarPubMed
10. Landolina, M, Perego, GB, Lunati, M, et al. Remote monitoring reduces healthcare use and improves quality of care in heart failure patients with implantable defibrillators: the evolution of management strategies of heart failure patients with implantable defibrillators (EVOLVO) study. Circulation 2012; 125: 2985–2992.Google Scholar
11. Furukawa, T, Maggi, R, Bertolone, C, et al. Effectiveness of remote monitoring in the management of syncope and palpitations. Europace 2011; 13: 431–437.Google Scholar
12. Raatikainen, MJ, Uusimaa, P, van Ginneken, MM, Janssen, JP, Linnaluoto, M. Remote monitoring of implantable cardioverter defibrillator patients: a safe, time-saving, and cost-effective means for follow-up. Europace 2008; 10: 1145–1151.CrossRefGoogle ScholarPubMed
13. Burri, H, Senouf, D. Remote monitoring and follow-up of pacemakers and implantable cardioverter defibrillators. Europace 2009; 11: 701–709.Google Scholar
14. Saxon, LA, Hayes, DL, Gilliam, FR, et al. Long-term outcome after ICD and CRT implantation and influence of remote device follow-up: the ALTITUDE survival study. Circulation 2010; 122: 2359–2367.CrossRefGoogle ScholarPubMed
15. Ricci, RP, Morichelli, L, D’Onofrio, A, et al. Effectiveness of remote monitoring of CIEDs in detection and treatment of clinical and device-related cardiovascular events in daily practice: the HomeGuide Registry. Europace 2013; 15: 970–977.Google Scholar
16. Spencker, S, Coban, N, Koch, L, Schirdewan, A, Muller, D. Potential role of home monitoring to reduce inappropriate shocks in implantable cardioverter-defibrillator patients due to lead failure. Europace 2009; 11: 483–488.Google Scholar
17. Varma, N, Michalski, J, Epstein, AE, Schweikert, R. Automatic remote monitoring of implantable cardioverter-defibrillator lead and generator performance: the Lumos-T Safely RedUceS RouTine Office Device Follow-Up (TRUST) trial. Circ Arrhythm Electrophysiol 2010; 3: 428–436.CrossRefGoogle ScholarPubMed
18. Halimi, F, Cantù, F. Remote monitoring for active cardiovascular implantable electronic devices: a European survey. Europace 2010; 12: 1778–1780.Google Scholar
19. Dubner, S, Auricchio, A, Steinberg, JS, et al. ISHNE/EHRA expert consensus on remote monitoring of cardiovascular implantable electronic devices (CIEDs). Europace 2012; 14: 278–293.CrossRefGoogle ScholarPubMed
20. Malloy, LE, Gingerich, J, Olson, MD, Atkins, DL. Remote monitoring of cardiovascular implantable devices in the pediatric population improves detection of adverse events. Pediatr Cardiol 2014; 35: 301–306.CrossRefGoogle ScholarPubMed
21. Zartner, PA, Toussaint-Goetz, N, Photiadis, J, Wiebe, W, Schneider, MB. Telemonitoring with implantable electronic devices in young patients with congenital heart diseases. Europace 2012; 14: 1030–1037.Google Scholar
22. De Asmundis, C, Ricciardi, D, Namdar, M, Chierchia, GB, Sarkozy, A, Brudaga, P. Role of home monitoring in children with implantable cardioverter defibrillators for Brugada syndrome. Europace 2013; 15 (Suppl 1): i17–i25.CrossRefGoogle ScholarPubMed
23. LaPage, MJ, von Alvensleben, J, Dick, M, Serwer, G, Bradley, DJ. Utility of intrathoracic impedance monitoring in pediatric and congenital heart disease. Pacing Clin Electrophysiol 2013; 36: 994–999.CrossRefGoogle ScholarPubMed
24. Ricci, RP, Morichelli, L. Workflow time and patient satisfaction from the perspective of home monitoring. Europace 2013; 15 (Suppl 1): i49–i53.CrossRefGoogle ScholarPubMed
25. Movsowitz, C, Mittal, S. Remote patient management using implantable devices. J Interv Card Electrophysiol 2011; 31: 81–90.CrossRefGoogle ScholarPubMed
26. Cronin, EM, Ching, EA, Varma, N, Martin, DO, Wilkoff, BL, Lindsay, BD. Remote monitoring of cardiovascular devices: a time and activity analysis. Heart Rhythm 2012; 9: 1947–1951.Google Scholar
27. Cronin, EM, Varma, N. Remote monitoring of cardiovascular implanted electronic devices: a paradigm shift for the 21st century. Expert Rev Med Devices 2012; 9: 367–376.Google Scholar
28. Ricci, RP, Morichelli, L, Santini, M. Home monitoring remote control of pacemaker and implantable cardioverter defibrillator patients in clinical practice: impact on medical management and health-care resource utilization. Europace 2008; 10: 164–170.CrossRefGoogle ScholarPubMed