Detecting early physiologic changes through cardiac implantable electronic device data among patients with COVID-19

Turchioe, Meghan Reading; Ahmed, Rayaz; Creber, Ruth Masterson; Axsom, Kelly; Horn, Evelyn M.; Sayer, Gabriel; Uriel, Nir; Steín, Kenneth M.; Slotwiner, David J.

doi:10.1016/j.cvdhj.2022.07.070

Cited by 1 publication

(1 citation statement)

References 18 publications

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“…For patients with significant cardiac disease and/or arrhythmias, implantable electronic devices such as permanent pacemakers, defibrillators, and cardiac resynchronization therapy (CRT) devices can assist with maintaining baseline cardiac function for the patient and the avoidance of life-threatening outcomes [ 4 ]. Sensors within the devices can transmit patient data such as respiratory rate (RR), physical activity levels (based on vital sign values), short recordings of intracardial cardiograms, heart rate (HR), night-time pulse, temperature, a rapid-shallow-breathing-index, thoracic impedance, and heart-sounds [ 5 ]. In addition, there is an algorithm within the devices that can use multiple sensors to track trends and alert providers if worsening heart conditions are identified in the patient [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Patient informed consent, ethical and legal considerations in the context of digital vulnerability with smart, cardiac implantable electronic devices

Torgersen,

Schulz,

Lugo

et al. 2024

PLOS Digit Health

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Advancements in digitalisation with cardiac implantable electronic devices (CIEDs) allow patients opportunities for improved autonomy, quality of life, and a potential increase in life expectancy. However, with the digital and functional practicalities of CIEDs, there exists also cyber safety issues with transferring wireless information. If a digital network were to be hacked, a CIED patient could experience both the loss of sensitive data and the loss of functional control of the CIED due to an unwelcome party. Moreover, if a CIED patient were to become victim of a cyber attack, which resulted in a serious or lethal event, and if this information were to become public, the trust in healthcare would be impacted and legal consequences could result. A cyber attack therefore poses not only a direct threat to the patient’s health but also the confidentiality, integrity, and availability of the CIED, and these cyber threats could be considered “patient-targeted threats.” Informed consent is a key component of ethical care, legally concordant practice, and promoting patient-as-partner therapeutic relationships [1]. To date, there are no standardised guidelines for listing cybersecurity risks within the informed consent or for discussing them during the consent process. Providers are responsible for adhering to the ethical principles of autonomy, beneficence, non-maleficence, and justice, both in medical practice generally and the informed consent process specifically. At present, the decision to include cybersecurity risks is mainly left to the provider’s discretion, who may also have limited cyber risk information. Without effective and in-depth communication about all possible cybersecurity risks during the consent process, CIED patients can be left unaware of the privacy and physical risks they possess by carrying such a device. Therefore, cyber risk factors should be covered within the patients’ informed consent and reviewed on an ongoing basis as new risk information becomes available. By including cyber risk information in the informed consent process, patients are given the autonomy to make the best-informed decision.

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Section: Introductionmentioning

confidence: 99%