Patient experiences of implantable cardiac monitoring in hypertrophic cardiomyopathy: an exploratory study

Abstract

Aim Hypertrophic cardiomyopathy (HCM) is the most common inherited heart disease. Insertable cardiac monitors (ICM) are increasingly used in this population to provide closer monitoring, with the potential for notification systems. However, little is known regarding the psychological impact this information may have for patients. The Abbott Confirm Rx™ ICM has the capability of connecting to the patient’s smartphone to enable active participation in their care, as well as two-way communication between the patient and their care-providers. This study aimed to explore individuals’ experiences of having a smartphone-enabled ICM to monitor for arrhythmias in HCM. Methods and Results Semi-structured interviews were conducted with 10 participants. Utilizing a grounded theory approach, the interview guide was modified based on emerging themes throughout the study. Reflexive thematic analysis was applied to categorize interview data into codes and overacting themes, with each interview independently coded by two study members. Analysis revealed three key themes 1) psychological impact 2) educational needs and 3) technology expectations. Participants reported that receiving feedback from ICM transmissions resulted in improved symptom clarity, providing reassurance and aiding ICD-decision-making. Some participants reported uncertainty regarding when to send manual transmissions. Lastly, participants reported the app interface did not meet expectations with regards to the amount of data available for patients. Conclusions Overall, utilizing a smartphone app to facilitate two-way communication of ICM transmissions was well-accepted. Future directions include addressing gaps in educational needs and improvements in the patient interface with increased access to data.