The Effectiveness of Transtelephonic Monitoring of Pacemaker Function in Pediatric Patients

Abstract

Values for sensitivity and specificity indicate that telephone transmission is a useful diagnostic tool for assessing pacemaker function at a distance. Negative predictive value is 99.9%, indicating that normal telephone transmissions are very reassuring of normal pacemaker function. Telephone transmission is equally successful in all age groups, genders, distances from a tertiary referral center, underlying diagnoses, pacing modes, and pacemaker models. Compliance with telephone transmission follow-up was higher in our population than in previous studies.

Usefulness of Transtelephonic Monitoring in Epicardial Pacemaker Systems

“…Routine TTM of pediatric patients with cardiac PM has been shown to have high sensitivity and specificity in identifying PM malfunction. 5 Multiple studies have shown that epicardial leads have a higher rate of lead failure than transvenous systems. 2,6,7 Whether there is a difference in the diagnosis of malfunction using TTM in patients with transvenous or epicardial systems is unknown.…”

“…TTM was first described in the early 1970s and has been used since for examination of sensing and stimulation function and to determine the battery status of the pulse generator. Routine TTM of pediatric patients with cardiac PM has been shown to have high sensitivity and specificity in identifying PM malfunction . Multiple studies have shown that epicardial leads have a higher rate of lead failure than transvenous systems .…”

Effectiveness and feasibility of a transtelephonic monitoring program: Implications for a time of crisis

“…A recent study showed that TTM has 94.8% sensitivity and 99.2% specificity and a positive predictive value of 82.1% and negative predictive value of 98.8% in diagnosing pacemaker dysfunction [2]. No deaths or serious complications relating to a failure to detect by TTM were reported.…”

“…Following cardiac pacemaker implantation it is standard practice to establish a follow-up program in order to detect signs that may indicate battery depletion or pacemaker malfunction [1][2][3][4][5][6][7]. This followup program ensures patient welfare and is chiefly performed in-person; supplemented with a transtelephonic monitoring program (TTM).…”

“…This followup program ensures patient welfare and is chiefly performed in-person; supplemented with a transtelephonic monitoring program (TTM). A TTM contact consists of an ECG transmitted via a telephone from the patient's home, evaluation of sensing and captures capabilities, and a magnetic estimation of the battery status [1,2,[8][9][10].…”