Remote monitoring of patients with biventricular defibrillators through the CareLink system improves clinical management of arrhythmias and heart failure episodes

Massimo Santini, Renato P. Ricci, Maurizio Lunati, Maurizio Landolina, Giovanni B. Perego, Maurizio Marzegalli, Milena Schirru, Chiara Belvito, Roberto Brambilla, Giuseppe Guenzati, Serena Gilardi, Sergio Valsecchi

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Purpose: The aim of the present study is to evaluate if remote monitoring with the CareLink Network may improve clinical management of tachyarrhythmias and heart failure episodes in patients treated with biventricular defibrillators (CRT-D). Methods: Patients implanted with CRT-D for more than 6 months received the CareLink monitor and were trained to perform device interrogation. At-home transmissions were scheduled at 2 weeks, 1 and 2 months after training, with a final in-office visit after 3 months. Results: Sixty-seven patients performed 264 data transmissions. Twenty-three unscheduled data transmissions were requested by the centers after patient contact. Ventricular tachyarrhythmias were reported in nine patients during 16 data reviews. Thirteen data reviews (81%) were performed remotely via CareLink transmissions (nine scheduled and four unscheduled), in seven patients. Of these events, in two cases (15%) in-hospital visits were requested, while in 11 (85%) no action was needed and no additional in-clinic visits were scheduled. During the study period, in 20/28 (71%) intra-thoracic impedance alerts, the patients remotely transmitted their device data. After remote data review, in ten cases drug therapy was adjusted by phone and in four cases no action was needed and the patient reassured. In six episodes an in-hospital extra visit was scheduled. On the whole, in 14 cases (70%), the patient could be managed remotely avoiding a visit to the hospital. Conclusions: Our study showed that remote follow-up is an efficient method to manage tachyarrhythmias and heart failure episodes in CRT-D patients. Early reaction to clinical events may improve overall patient care.

Original languageEnglish
Pages (from-to)53-61
Number of pages9
JournalJournal of Interventional Cardiac Electrophysiology
Volume24
Issue number1
DOIs
Publication statusPublished - Jan 2009

Fingerprint

Defibrillators
Physiologic Monitoring
Cardiac Arrhythmias
Heart Failure
Tachycardia
Office Visits
Equipment and Supplies
Ambulatory Care
Electric Impedance
Patient Care
Thorax
Drug Therapy

Keywords

  • Cardiac resynchronization therapy
  • Defibrillator
  • Heart failure
  • Home monitoring
  • Remote control
  • Tachyarrhythmias

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Remote monitoring of patients with biventricular defibrillators through the CareLink system improves clinical management of arrhythmias and heart failure episodes. / Santini, Massimo; Ricci, Renato P.; Lunati, Maurizio; Landolina, Maurizio; Perego, Giovanni B.; Marzegalli, Maurizio; Schirru, Milena; Belvito, Chiara; Brambilla, Roberto; Guenzati, Giuseppe; Gilardi, Serena; Valsecchi, Sergio.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 24, No. 1, 01.2009, p. 53-61.

Research output: Contribution to journalArticle

Santini, M, Ricci, RP, Lunati, M, Landolina, M, Perego, GB, Marzegalli, M, Schirru, M, Belvito, C, Brambilla, R, Guenzati, G, Gilardi, S & Valsecchi, S 2009, 'Remote monitoring of patients with biventricular defibrillators through the CareLink system improves clinical management of arrhythmias and heart failure episodes', Journal of Interventional Cardiac Electrophysiology, vol. 24, no. 1, pp. 53-61. https://doi.org/10.1007/s10840-008-9321-3
Santini, Massimo ; Ricci, Renato P. ; Lunati, Maurizio ; Landolina, Maurizio ; Perego, Giovanni B. ; Marzegalli, Maurizio ; Schirru, Milena ; Belvito, Chiara ; Brambilla, Roberto ; Guenzati, Giuseppe ; Gilardi, Serena ; Valsecchi, Sergio. / Remote monitoring of patients with biventricular defibrillators through the CareLink system improves clinical management of arrhythmias and heart failure episodes. In: Journal of Interventional Cardiac Electrophysiology. 2009 ; Vol. 24, No. 1. pp. 53-61.
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abstract = "Purpose: The aim of the present study is to evaluate if remote monitoring with the CareLink Network may improve clinical management of tachyarrhythmias and heart failure episodes in patients treated with biventricular defibrillators (CRT-D). Methods: Patients implanted with CRT-D for more than 6 months received the CareLink monitor and were trained to perform device interrogation. At-home transmissions were scheduled at 2 weeks, 1 and 2 months after training, with a final in-office visit after 3 months. Results: Sixty-seven patients performed 264 data transmissions. Twenty-three unscheduled data transmissions were requested by the centers after patient contact. Ventricular tachyarrhythmias were reported in nine patients during 16 data reviews. Thirteen data reviews (81{\%}) were performed remotely via CareLink transmissions (nine scheduled and four unscheduled), in seven patients. Of these events, in two cases (15{\%}) in-hospital visits were requested, while in 11 (85{\%}) no action was needed and no additional in-clinic visits were scheduled. During the study period, in 20/28 (71{\%}) intra-thoracic impedance alerts, the patients remotely transmitted their device data. After remote data review, in ten cases drug therapy was adjusted by phone and in four cases no action was needed and the patient reassured. In six episodes an in-hospital extra visit was scheduled. On the whole, in 14 cases (70{\%}), the patient could be managed remotely avoiding a visit to the hospital. Conclusions: Our study showed that remote follow-up is an efficient method to manage tachyarrhythmias and heart failure episodes in CRT-D patients. Early reaction to clinical events may improve overall patient care.",
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AU - Perego, Giovanni B.

AU - Marzegalli, Maurizio

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