Advances in remote monitoring of implantable pacemakers, cardioverter defibrillators and cardiac resynchronization therapy systems

Abstract

Unlike the standard quarterly or semi-annual direct ambulatory device interrogations procedures, state-of-the-art implantable electronic cardiovascular devices (IECD) enable their wireless remote interrogation and monitoring, and automatically send reports and special alerts on a daily basis. This allows physicians to respond more proactively to changes in patient or device status, more appropriately triage patient care, and more efficiently perform the post-implant ambulatory follow-ups. This review presents the-state-of the-art technology of remote IECD monitoring and summarizes the main clinical observations published through June 2008. Cardiovascular remote monitoring systems made by several manufacturers are currently in various phases of development, clinical investigation, and medical applications. Data collected in several completed and ongoing studies strongly suggest that this new technology will make important contributions, particularly with respect to the facilitation of IECD follow-ups, enhancement of patient safety and quality of life, and lowering of medical costs. Further technological advances and a more clear understanding and appreciation of the clinical and economic benefits of telecardiology, will likely increase sharply the use of remote IECD monitoring in upcoming years.

Remote monitoring of patients with cardiac implantable electronic devices: a Southeast Asian, single-centre pilot study

“…Their overall satisfaction was consistent with high satisfaction rates worldwide from enhancement of patients' quality of life. (6,11,(31)(32)(33) This preference for remote monitoring, regardless of geographic proximity, could perhaps be extrapolated to countries where there are doubts as to whether implementation of remote monitoring would benefit patients living near a monitoring centre. It may also be applied to some city-dwelling patients who are in close proximity to a monitoring centre but are hampered by mobility problems, work schedules or poor traffic conditions.…”

The Role of Standard 12-lead ECG in a Telecardiology Consultation Service

“…Telecardiology encompasses a wide variety of applications. Over 200.000 patients worldwide are being managed via remote implantable electronic cardiovascular device monitoring to facilitate the recognition of abnormal device behaviour and verify the patient's immediate physiological response to the many programmable therapies the devices offer (Jung et al, 2008). Data collected in several completed and ongoing studies strongly suggest that this new technology will make important contributions, particularly with respect to the facilitation of device follow-ups, enhancement of patient safety and quality of life, and lowering of medical costs.…”

MRI-based communication for untethered intelligent medical microrobots

“…In our proposed microrobot, we use a photovoltaic cell as a power supply as presented in [18] while an ion-sensitive field-effect transistor (ISFET) could be exploited as a sensor and a miniature coil acts as a transmitter. The communication methods for in-vivo application are mainly investigated in the literature for medical implants [19][20][21][22][23][24] such as implantable pacemakers and defibrillators [20,25,26], insulin pumps [21], hearing aids [22] or robotic endoscopy [27][28][29][30]. For instance, Ghovanloo et al [19] developed a high-rate phase-coherent FSK modulation protocol, a wideband inductive link, and three FSK demodulator circuits which are used in wireless implantable neural micro stimulation.…”

“…The communication methods for in-vivo application are mainly investigated in the literature for medical implants [19][20][21][22][23][24], such as implantable pacemakers and defibrillators [20,25,26], insulin pumps [21], or hearing aids [22] or robotic endoscopy [27][28][29][30].…”