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Der Diabetologe

, Volume 8, Issue 4, pp 291–297 | Cite as

Telekardiologie

  • J. Franke
  • C. Zugck
  • H.A. Katus
Leitthema
  • 133 Downloads

Zusammenfassung

Die Telekardiologie gehört zu den fortschrittlichsten Bereichen der Telemedizin. Sie macht Gebrauch vom neuesten Stand der Kommunikations- sowie Medizintechnik und kommt bei diversen kardiovaskulären Erkrankungen sowohl im diagnostischen als auch im therapeutischen Bereich zum Einsatz. So weist die Telekardiologie das Potenzial auf, die medizinische Versorgung auf vielfältige Weise zu verbessern, vorrangig die Lebensqualität der Patienten sowie deren kardiovaskuläre Morbidität und Mortalität zu reduzieren. Der vorliegende Beitrag konzentriert sich auf Konzepte der Telekardiologie in Anwendungsgebieten der chronischen Herzinsuffizienz, der Arrhythmiediagnostik und der Überwachung von medizinelektronischen Implantaten.

Schlüsselwörter

Telemedizin Herzinsuffizienz Arrhythmien, kardiale Elektrokardiographie Elektroden, implantierte 

Telecardiology

Abstract

Telecardiology belongs to the most advanced fields in telemedicine. It facilitates state-of-the-art communication and medical device technology and can support diagnostic and therapeutic measures of heart disease. Thus, telecardiology has the potential to improve health care in various ways, most importantly by improving quality of life and by reducing cardiovascular morbidity and mortality. This present article reviews current concepts of telecardiology in the fields of chronic heart failure, arrhythmia and device monitoring.

Keywords

Telemedicine Heart failure Arrhythmias, cardiac Electrocardiography Electrodes, implanted 

Notes

Interessenkonflikt

Die korrespondierende Autorin weist für sich und ihre Koautoren auf folgende Beziehungen hin: C. Zugck erhält Vortragshonorare von den Firmen SHL Telemedizin, Servier, Novartis, Pfizer sowie AstraZenica. H.A. Katus erhält ein Beraterhonorar von der Fa. SHL Telemedizin. Die Heidelberger Telemedizin Studie „HeiTel“ wird gefördert und finanziert im Rahmen eines integrierten Versorgungsvertrags der AOK Baden-Württemberg und SHL Telemedizin.

Literatur

  1. 1.
    Abraham WT, Adamson PB, Bourge RC et al (2011) Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial. Lancet 377:658–666PubMedCrossRefGoogle Scholar
  2. 2.
    Al-Khatib SM, Piccini JP, Knight D et al (2010) Remote monitoring of implantable cardioverter defibrillators versus quarterly device interrogations in clinic: results from a randomized pilot clinical trial. J Cardiovasc Electrophysiol 21:545–550PubMedCrossRefGoogle Scholar
  3. 3.
    Brignole M, Menozzi C, Maggi R et al (2005) The usage and diagnostic yield of the implantable loop-recorder in detection of the mechanism of syncope and in guiding effective antiarrhythmic therapy in older people. Europace 7:273–279PubMedCrossRefGoogle Scholar
  4. 4.
    Brignole M, Vardas P, Hoffman E et al (2009) Indications for the use of diagnostic implantable and external ECG loop recorders. Europace 11:671–687PubMedCrossRefGoogle Scholar
  5. 5.
    Chaudhry SI, Mattera JA, Curtis JP et al (2010) Telemonitoring in patients with heart failure. N Engl J Med 363:2301–2309PubMedCrossRefGoogle Scholar
  6. 6.
    Cleland JG, Louis AA, Rigby AS et al (2005) Noninvasive home telemonitoring for patients with heart failure at high risk of recurrent admission and death: the Trans-European Network-Home-Care Management System (TEN-HMS) study. J Am Coll Cardiol 45:1654–1664PubMedCrossRefGoogle Scholar
  7. 7.
    Cleland JG, Swedberg K, Follath F et al (2003) The EuroHeart Failure survey programme– a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. Eur Heart J 24:442–463PubMedCrossRefGoogle Scholar
  8. 8.
    Dickstein K, Cohen-Solal A, Filippatos G et al (2008) ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J 29:2388–2442PubMedCrossRefGoogle Scholar
  9. 9.
    Dickstein K, Vardas PE, Auricchio A et al (2010) 2010 focused update of ESC guidelines on device therapy in heart failure: an update of the 2008 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure and the 2007 ESC guidelines for cardiac and resynchronization therapy. Developed with the special contribution of the Heart Failure Association and the European Heart Rhythm Association. Eur J Heart Fail 12:1143–1153PubMedCrossRefGoogle Scholar
  10. 10.
    Inglis SC, Clark RA, McAlister FA et al (2011) Which components of heart failure programmes are effective? A systematic review and meta-analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8323 patients: Abridged Cochrane Review. Eur J Heart Fail 13:1028–1040PubMedCrossRefGoogle Scholar
  11. 11.
    Klersy C, De Silvestri A, Gabutti G et al (2009) A meta-analysis of remote monitoring of heart failure patients. J Am Coll Cardiol 54:1683–1694PubMedCrossRefGoogle Scholar
  12. 12.
    Klingenheben T, Israel CW (2006) Use of telemedicine in the diagnosis of paroxysmal atrial fibrillation and to monitor the effect of antiarrhythmic drug therapy. Herzschrittmacherther Elektrophysiol 17:225–228PubMedCrossRefGoogle Scholar
  13. 13.
    Koehler F, Winkler S, Schieber M et al (2011) Impact of remote telemedical management on mortality and hospitalizations in ambulatory patients with chronic heart failure: the telemedical interventional monitoring in heart failure study. Circulation 123:1873–1880PubMedCrossRefGoogle Scholar
  14. 14.
    Krahn AD, Klein GJ, Yee R et al (1999) Use of an extended monitoring strategy in patients with problematic syncope. Circulation 99:406–410PubMedCrossRefGoogle Scholar
  15. 15.
    Lloyd-Jones DM, Larson MG, Leip EP et al (2002) Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation 106:3068–3072PubMedCrossRefGoogle Scholar
  16. 16.
    McMurray JJ, Stewart S (2000) Epidemiology, aetiology, and prognosis of heart failure. Heart 83:596–602PubMedCrossRefGoogle Scholar
  17. 17.
    Müller A, Helms T, Wildau HJ et al (2011) Remote monitoring in patients with pacemakers and implantable cardioverter-defibrillators: new perspectives for complex therapy management. In: Kumar M (Hrsg) Modern pacemakers – present and future. InTech, Rijeka, S 147–166Google Scholar
  18. 18.
    Osterberg L, Blaschke T (2005) Adherence to medication. N Engl J Med 353:487–497PubMedCrossRefGoogle Scholar
  19. 19.
    Patten M, Maas R, Karim A et al (2006) Event-recorder monitoring in the diagnosis of atrial fibrillation in symptomatic patients: subanalysis of the SOPAT trial. J Cardiovasc Electrophysiol 17:1216–1220PubMedCrossRefGoogle Scholar
  20. 20.
    Raatikainen MJ, Uusimaa P, Van Ginneken MM et al (2008) Remote monitoring of implantable cardioverter defibrillator patients: a safe, time-saving, and cost-effective means for follow-up. Europace 10:1145–1151PubMedCrossRefGoogle Scholar
  21. 21.
    Schoenfeld MH, Compton SJ, Mead RH et al (2004) Remote monitoring of implantable cardioverter defibrillators: a prospective analysis. Pacing Clin Electrophysiol 27:757–763PubMedCrossRefGoogle Scholar
  22. 22.
    Senatore G, Stabile G, Bertaglia E et al (2005) Role of transtelephonic electrocardiographic monitoring in detecting short-term arrhythmia recurrences after radiofrequency ablation in patients with atrial fibrillation. J Am Coll Cardiol 45:873–876PubMedCrossRefGoogle Scholar
  23. 23.
    Statistisches Bundesamt Deutschland G (2004) Anzahl der Gestorbenen nach Kapiteln der ICD-10. http://www.destatis.de/basis/ d/gesu/gesutab19.htmGoogle Scholar
  24. 24.
    Vik SA, Hogan DB, Patten SB et al (2006) Medication nonadherence and subsequent risk of hospitalisation and mortality among older adults. Drugs Aging 23:345–356PubMedCrossRefGoogle Scholar
  25. 25.
    Wallbruck K, Stellbrink C, Santini M et al (2002) The value of permanent follow-up of implantable pacemakers-first results of an European trial. Biomed Tech (Berl) 47(Suppl 1 Pt 2):950–953Google Scholar
  26. 26.
    Wilkoff BL, Auricchio A, Brugada J et al (2008) HRS/EHRA Expert Consensus on the Monitoring of Cardiovascular Implantable Electronic Devices (CIEDs): description of techniques, indications, personnel, frequency and ethical considerations: developed in partnership with the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA); and in collaboration with the American College of Cardiology (ACC), the American Heart Association (AHA), the European Society of Cardiology (ESC), the Heart Failure Association of ESC (HFA), and the Heart Failure Society of America (HFSA). Endorsed by the Heart Rhythm Society, the European Heart Rhythm Association (a registered branch of the ESC), the American College of Cardiology, the American Heart Association. Europace 10:707–725PubMedCrossRefGoogle Scholar
  27. 27.
    Woodend AK, Sherrard H, Fraser M et al (2008) Telehome monitoring in patients with cardiac disease who are at high risk of readmission. Heart Lung 37:36–45PubMedCrossRefGoogle Scholar
  28. 28.
    Zugck C, Nelles M, Frankenstein L et al (2005) Telemonitoring in chronic heart failure patients. Which diagnostic finding prevents hospital readmission? Herzschrittmacherther Elektrophysiol 16:176–182PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Innere Medizin III, Kardiologie, Angiologie und PneumologieUniversitätsklinikum HeidelbergHeidelbergDeutschland

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