Remote Monitoring of CRT‐ICD: The Multicenter Italian CareLink Evaluation—Ease of Use, Acceptance, and Organizational Implications

Marzegalli, Maurizio; Lunati, Maurizio; Landolina, Maurizio; Perego, Giovanni Battista; Ricci, Renato Pietro; Guenzati, Giuseppe; Schirru, Milena; Belvito, Chiara; Brambilla, Roberto; Masella, Cristina; Stasi, F Di; Valsecchi, Sergio; Santini, Massimo

doi:10.1111/j.1540-8159.2008.01175.x

Cited by 115 publications

(85 citation statements)

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“…14 Moreover, it has been suggested that, by improving the clinical management of tachyarrhythmias and HF episodes in ICD patients, 15 remote monitoring could lead to a reduction in healthcare use. In particular, it could be effective in decreasing unplanned in-office visits, which are more costly than scheduled visits in terms of time dedicated by specialized personnel because they take Ϸ30% longer.…”

Section: Discussionmentioning

confidence: 99%

Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators

et al. 2012

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Background-Heart failure patients with implantable cardioverter-defibrillators (ICDs) or an ICD for resynchronization therapy often visit the hospital for unscheduled examinations, placing a great burden on healthcare providers. We hypothesized that Internet-based remote interrogation systems could reduce emergency healthcare visits. Methods and Results-This multicenter randomized trial involving 200 patients compared remote monitoring with standard patient management consisting of scheduled visits and patient response to audible ICD alerts. The primary end point was the rate of emergency department or urgent in-office visits for heart failure, arrhythmias, or ICD-related events. Over 16 months, such visits were 35% less frequent in the remote arm (75 versus 117; incidence density, 0.59 versus 0.93 events per year; Pϭ0.005). A 21% difference was observed in the rates of total healthcare visits for heart failure, arrhythmias, or ICD-related events (4.40 versus 5.74 events per year; PϽ0.001). The time from an ICD alert condition to review of the data was reduced from 24.8 days in the standard arm to 1.4 days in the remote arm (PϽ0.001). The patients' clinical status, as measured by the Clinical Composite Score, was similar in the 2 groups, whereas a more favorable change in quality of life (Minnesota Living With Heart Failure Questionnaire) was observed from the baseline to the 16th month in the remote arm (Pϭ0.026). Conclusions-Remote monitoring reduces emergency department/urgent in-office visits and, in general, total healthcare use in patients with ICD or defibrillators for resynchronization therapy. Compared with standard follow-up through in-office visits and audible ICD alerts, remote monitoring results in increased efficiency for healthcare providers and improved quality of care for patients. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00873899.

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Section: Discussionmentioning

confidence: 99%

Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators

et al. 2012

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“…Uma análise de qualidade de vida com o questionário SF-36 mostrou que 93 a 97% dos doentes se encontram satisfeitos com a conveniência e exequibilidade do sistema de monitorização à distância 27 . Diferentes estudos, em doentes com CDI ou com TRC-D, revelaram níveis de satisfação elevados quer nos doentes, que nos médicos 11,28 .…”

Section: Custo-benefício Da Monitorização à Distânciaunclassified

Monitorização à distância no seguimento de portadores de dispositivos cardíacos implantados

Oliveira

Cunha

Silva

2013

Revista Portuguesa de Cardiologia

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PALAVRAS-CHAVEResumo O aumento significativo registado nas implantações de dispositivos cardíacos, sobretudo como consequência dos benefícios demonstrados com a utilização de cardioversoresdesfibrilhadores e sistemas de ressincronização cardíaca na redução da mortalidade, trouxe para a prática clínica hospitalar o problema da gestão de recursos para responder ao crescimento exponencial do número de doentes em consultas regulares de seguimento especializado. A era das tecnologias da comunicação permitiu desenvolver sistemas de monitorização à distância, que são hoje uma realidade em franca expansão na Europa e nos Estados Unidos, com diversas vantagens e níveis de eficácia e segurança bem documentados. A sua utilização tem permitido obter um elevado grau de satisfação para o doente e médico, reduzindo o número de visitas hospitalares e os custos inerentes ao seguimento desta população. Os resultados dos diferentes estudos têm mostrado elevada capacidade na deteção mais precoce de problemas clínicos, arrítmicos ou de descompensação da insuficiência cardíaca, e de anomalias no funcionamento do dispositivo implantado. Apesar da experiência favorável com o recurso a esta metodologia de follow-up, são necessários estudos para avaliar o seu impacto clínico a longo prazo, em comparação com as consultas convencionais, bem como a introdução e adaptação da legislação referente a este tipo de evolução tecnológica aplicada à saúde. No presente artigo, revimos os aspetos técnicos e a evidência recente da relevância clínica da monitorização à distância em portadores de dispositivos cardíacos implantados. © 2011 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L. Todos os direitos reservados. KEYWORDSRemote monitoring; Implantable cardioverterdefibrillator; Remote monitoring for follow-up of patients with implantable cardiac devicesAbstract With a widening of indications for cardiac devices, especially in view of the clinical benefits of implantable cardioverter-defibrillators and cardiac resynchronization therapy, the number of patients with such devices is growing steadily. However, the resources required, and the need for long-term regular interrogation in dedicated clinics, represent a significant burden * Autor para correspondência. Correio eletrónico: m.martinsoliveira@gmail.com (M. Oliveira).

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“…Several studies have shown a high degree of patient satisfaction with the convenience and ease of use of remote monitoring systems (Marzegalli et al, 2008, Masella et al, 2008, Raatikainen et al, 2008. From a patient's perspective, the biggest value of remote monitoring is convenience with fewer in-clinic visits and less time traveling to and from their clinics.…”

Section: Patient Preferencementioning

confidence: 99%

“…Remote monitoring also leads to greater patient reassurance and improved patient follow-up adherence (Varma et al, 2010). Most patients prefer remote monitoring over in-clinic visits (Marzegalli et al, 2008, Masella et al, 2008. In TRUST trial, 98% of patients elected to retain remote monitoring as a follow-up mode on trial conclusion (Varma et al, 2010).…”

Section: Patient Preferencementioning

confidence: 99%

Remote Monitoring of Implantable Cardioverter-Defibrillator Therapy

Raatikainen¹,

Koivisto²

2011

Cardiac Defibrillation - Mechanisms, Challenges and Implications

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Remote Monitoring of CRT‐ICD: The Multicenter Italian CareLink Evaluation—Ease of Use, Acceptance, and Organizational Implications

Abstract: The ease of use, satisfaction, and acceptance of the CareLink Network in European clinical practice appears elevated both for patients and for clinicians.

Cited by 115 publications

References 13 publications

Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators

Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators

Monitorização à distância no seguimento de portadores de dispositivos cardíacos implantados

Remote Monitoring of Implantable Cardioverter-Defibrillator Therapy

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