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

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

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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Acknowledgements

The authors would like to thank Walter Bernardini and Marco Vimercati (clinical service team, Medtronic Italy) for the data management, and Jane Moore for her assistance in the editing of this manuscript.

Conflict of Interest Disclosure

Serena Gilardi and Sergio Valsecchi are employees of Medtronic, Inc.

No other conflicts exist.

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Authors and Affiliations

  1. Department of Cardiology, San Filippo Neri Hospital, Via Martinotti, 20, 00135, Rome, Italy

    Massimo Santini & Renato P. Ricci

  2. Niguarda Hospital, Milan, Italy

    Maurizio Lunati & Milena Schirru

  3. Fondazione Policlinico S. Matteo IRCCS, Pavia, Italy

    Maurizio Landolina & Chiara Belvito

  4. Istituto Auxologico S. Luca Hospital, Milan, Italy

    Giovanni B. Perego & Roberto Brambilla

  5. S. Carlo Borromeo Hospital, Milan, Italy

    Maurizio Marzegalli & Giuseppe Guenzati

  6. Medtronic Italia, Rome, Italy

    Serena Gilardi & Sergio Valsecchi

Authors
  1. Massimo Santini
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  2. Renato P. Ricci
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  3. Maurizio Lunati
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  4. Maurizio Landolina
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Correspondence to Massimo Santini.

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Santini, M., Ricci, R.P., Lunati, M. et al. Remote monitoring of patients with biventricular defibrillators through the CareLink system improves clinical management of arrhythmias and heart failure episodes. J Interv Card Electrophysiol 24, 53–61 (2009). https://doi.org/10.1007/s10840-008-9321-3

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  • DOI: https://doi.org/10.1007/s10840-008-9321-3

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