Remote monitoring in implantable defibrillator therapy

Abstract

The major device manufacturers have introduced systems for remote patient monitoring. These remote monitoring systems promise more efficient patient management, especially in today's clinical setting with the growing number of defibrillator implantations. The aim of this article is to present the role of remote patient monitoring in implantable cardioverter-defibrillator follow-up, its potential benefits and its barriers to widespread diffusion. (Neth Heart J 2008;16:53-6.)

A Review on Remote Monitoring Technology Applied to Implantable Electronic Cardiovascular Devices

“…10,11,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] A first overview on the selected papers allowed us to place them in terms of type, time, and location while exploring the issues each of them covers.…”

“…Identifying abnormal device functions 10,11,17,20,[24][25][26][27]31,32 Does not allow remote reprogramming 17,19,24 Patients' clinical stability Most current remote systems do not allow determination of pacing threshold 24 Prediction of hospitalization 10,26,31,32 Changes in patients' clinical status 11,17,26 Helping in the design of individualized follow-up 11,31 Time savings…”

“…The challenge is to be able to avoid routine follow-up visits such as integrity check and/or confirmation that no arrhythmic events or IECD-related issues occurred. 31 These systems, while enormously reducing the economic impact of unscheduled follow-up sessions (and the inherent cost of a possible admission and treatment), still have some problems regarding healthcare provider's reimbursement. 11,29,30,33 Also, remotely reprogramming IECDs have additional caveats, both technical and ethical, that need to be addressed before widespread implementation will be possible.…”

“…Remote monitoring of implanted ICDs is, in contrast to pacers, a relatively recent development. 11,31,32 The demographic increase in mean age of populations along with the incremental cost of the provision of healthcare has a severe impact on health and, therefore, leads to increasing requirements of technological applications to reduce costs as well as improving healthcare. Although these applications have a widely recognized value, they cannot entirely replace human contact, namely in traditional follow-up and, thus, need to be complementary with each other.…”

Use of remote monitoring in the management of system-related complications in implantable defibrillator patients

“…The major limitation of conventional follow-up is the lack of information on system performance and the clinical status of the patient between hospital visits. Remote monitoring of devices offers a possibility for continuous surveillance and rapid event identification notification [6,7]. The aim of this article is to present the role of remote patient monitoring in ICD follow-up, its potential benefits and its barriers in the management of system-related complications.…”