Remote monitoring of cardiac implantable electronic devices (CIED)

Abstract

With increasing indications and access to cardiac implantable electronic devices (CIEDs) worldwide, the number of patients needing CIED follow up continues to rise. In parallel, the technology available for managing these devices has advanced considerably. In this setting, remote monitoring (RM) has emerged as a complement to routine in-office care. Rigorous studies, randomized and otherwise, have demonstrated advantages to CIED patient management systems which incorporates RM resulting in authoritative guidelines from relevant professional societies recommending RM for all eligible patients. In addition to clinical benefits, CIED management programs that include RM have been shown to be cost effective and associated with high patient satisfaction. Finally, RM programs hold promise for the future of CIED research in light of the massive data collected through RM databases converging with unprecedented computational capability. This review outlines the available data associated with clinical outcomes in patients managed with RM with an emphasis on randomized trials; the impact of RM on patient satisfaction, cost-effectiveness and healthcare utilization; and possible future directions for the use of RM in clinical practice and research.

Multicenter Analysis of Dosing Protocols for Sotalol Initiation

“…Noteworthy is that patients with a pacemaker present were significantly less likely to have a dose adjustment, and more likely to successfully initiate sotalol than those without, perhaps due to less bradycardia, which was a key reason for failure of initiation. Given the continued advances in remote monitoring of cardiac implantable devices 27, 28 , as well as development of wearable/portable devices for measuring QT interval 29, 30 , it seems that our findings support the possibility that these patients could undergo outpatient initiation of sotalol, although more work is clearly needed.…”

Remote monitoring of implanted cardiac devices: A guide for patients and families

“…That means you may not need to go to the clinic as often for routine device follow‐up appointments. Problems with your cardiac device or abnormal heart rhythms may be detected earlier and allow your healthcare team to respond faster by adjusting your medications or treatment plan, as needed Remote monitoring, if used correctly, may reduce the occurrence of inappropriate ICD shocks or the need for hospitalization, and may improve device function and quality of life . Additionally, some research studies have shown that remote monitoring may improve survival but other studies have not found a survival benefit …”

“…3,4 • Remote monitoring, if used correctly, may reduce the occurrence of inappropriate ICD shocks or the need for hospitalization, and may improve device function and quality of life. [5][6][7][8] Additionally,…”

Biomedical health monitoring system design and analysis

“…In [10], 21% of health remote monitoring patients are not willing to use the system device. Redundant wiring is one of the reasons in [2] as it leads to obstruction of mobility, hazard and discomfort for the babies.…”

“…Redundant wiring is one of the reasons in [2] as it leads to obstruction of mobility, hazard and discomfort for the babies. While in [10,11], the efficiency of the device also needs to be considered and has yet to be analysed. Lower cost devices [12] that are more compact and [11] and have low power consumption for ease of mobility are preferred.…”