Improving Atrial Fibrillation Detection in Patients with Implantable Cardiac Devices by Means of a Remote Monitoring and Management Application

Zoppo, Franco; Facchin, Domenico; Molon, Giulio; Zanotto, Gabriele; Catanzariti, Domenico; Rossillo, Antonio; Baccillieri, S.; Menard, Cecile; Comisso, Jennifer; Gentili, Alessandra; Grammatico, Andrea; Bertaglia, Emanuele; Proclemer, Alessandro

doi:10.1111/pace.12474

Cited by 13 publications

(3 citation statements)

References 32 publications

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“…For example, algorithms to optimize scanning of all transmissions to identify CIED patients with AF enhanced AF detection sensitivity by 10% and improved oral anticoagulation optimal treatment by 6%. 145 An AI tool to filter AF alerts resulted in an 84% reduction in notification workload, while preserving patient safety. 146 Interestingly, neural network modelling of remotely acquired device-based data helped to identify patients at risk of malignant ventricular arrhythmias and appropriate device therapies within 30 days.…”

Section: Transition To Digital Healthmentioning

confidence: 99%

Remote monitoring of cardiac implantable electronic devices and disease management

Varma,

Braunschweig,

Burri

et al. 2023

Europace

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This reviews the transition of remote monitoring of patients with cardiac electronic implantable devices from curiosity to standard of care. This has been delivered by technology evolution from patient-activated remote interrogations at appointed intervals to continuous monitoring that automatically flags clinically actionable information to the clinic for review. This model has facilitated follow-up and received professional society recommendations. Additionally, continuous monitoring has provided a new level of granularity of diagnostic data enabling extension of patient management from device to disease management. This ushers in an era of digital medicine with wider applications in cardiovascular medicine.

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Section: Transition To Digital Healthmentioning

confidence: 99%

Remote monitoring of cardiac implantable electronic devices and disease management

Varma,

Braunschweig,

Burri

et al. 2023

Europace

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show abstract

“…La detección de FA silente por los DCEI nos ofrece la posibilidad de una intervención temprana, y varios estudios han demostrado la eficacia de la monitorización remota en el diagnóstico precoz de la FA y en el inicio temprano de la terapia anticoagulante en el caso de estar indicada 3 .…”

Section: ¿Cuándo Está Indicada La Anticoagulación?unclassified

Aplicaciones de los marcapasos y desfibriladores implantables que pueden mejorar nuestra práctica clínica

2015

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“…A number of studies have recently demonstrated that RM reduces the total number of in-office visits, [4,6] without negative effects on patient outcome; [7,8] some studies have also shown the positive clinical impact of RM. [9][10][11][12] Although RM can reduce clinical staff time compared to standard in-office follow-up, [13][14][15] organizational workflow changes and a new definition of roles and responsibilities may be needed to review remote transmissions in an effective, efficient and timely manner. [16] Considering that most RM data does not require any clinical escalation, [1,14] it has been hypothesized that the remote triage may be outsourced and that this would optimize the time allocation of highly skilled healthcare professionals.…”

Section: Introductionmentioning

confidence: 99%

Outsourcing the Remote Management of Cardiac Implantable Electronic Devices: Medical Care Quality Improvement Project (Preprint)

Giannola¹,

Torcivia²,

Farulla³

et al. 2018

Preprint

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Strucured Abstract Background:Remote management is partially replacing routine follow-up in patients implanted with cardiac implantable electronic devices. While it reduces clinical staff time compared to standard in-office follow-up, new definition of roles and responsibilities may be needed to review remote transmissions in an effective, efficient and timely manner. If the remote triage may be outsourced is still unclear. Objectives:The aim of this healthcare quality improvememt project was to assess if outsourcing the triage of cardiac implantable devices (CIEDs) remote follow-up is safe, effective and efficient to manage clinical and technical events and can improve resource utilization. Methods:Patients (N=153) with implanted CIEDs were followed up for 8 months. An external remote monitoring center (ERMC) composed of nurses and physicians reviewed remote transmissions daily following a specific remote monitoring (RM) protocol. A benchmarking phase with the standard RM management, where patients transmissions were managed directly by the hospital staff, was performed as a term of comparison. Results:A total of 654 transmissions were recorded in the RM system and managed by the ERMC team within 2 working days, showing a significant time reduction compared with standard RM management (100% vs 11% respectively within 2 days, p<0.001). 84% of the transmissions did not include a prioritized event and did not require escalation to the hospital clinician. Highpriority was assigned to 15 (2.3%) transmissions, which were communicated to the hospital team by email within 1 working day. Non-urgent device status events occurred in 88 cases and were communicated to the hospital within 2 working days. Overall, 10 (9.7%) transmissions were followed by a hospitalization. Conclusions:The outsourcing of RM management to an ERMC safely provides efficacy and efficiency gains in patients care compared with a standard in hospital management. Moreover the externalization of RM management could be a key tool to save dedicated staff and facility time with possible positive economic impact.

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Improving Atrial Fibrillation Detection in Patients with Implantable Cardiac Devices by Means of a Remote Monitoring and Management Application

Abstract: The AFinder web-based software, applied on top of standard in-hospital and remote monitoring, improved AF detection and enabled OAC treatment to be undertaken.

Cited by 13 publications

References 32 publications

Remote monitoring of cardiac implantable electronic devices and disease management

Remote monitoring of cardiac implantable electronic devices and disease management

Aplicaciones de los marcapasos y desfibriladores implantables que pueden mejorar nuestra práctica clínica

Outsourcing the Remote Management of Cardiac Implantable Electronic Devices: Medical Care Quality Improvement Project (Preprint)

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