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Remote patient management using implantable devices

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Abstract

Remote patient management utilizing the Internet is a milestone in the management of patients with an implantable cardiac device. Pacemakers and implantable cardioverter–defibrillators (ICDs) store diagnostic information about device and lead integrity, the occurrence of atrial and ventricular arrhythmias, and parameters that may reflect on a patient’s heart failure status. Previously, these data could only be retrieved with a programmer at an in-person office visit. The introduction of remote follow-up and monitoring has changed the paradigm for the management of patients with implanted devices. Remote follow-up has been shown to be superior to traditional transtelephonic monitoring for the detection of clinically actionable events in pacemaker patients. Remote monitoring using ICDs with wireless technology has been demonstrated to result in detection of lead malfunction and atrial and ventricular arrhythmias while reducing the need for in-office evaluations without compromising patient safety. Studies are underway to evaluate the clinical utility of identification of atrial high-rate episodes and to identify patients at risk for exacerbation of heart failure. Remote monitoring technology has yet to be universally adopted by patients or physicians. Impediments to the implementation of remote monitoring including issues related to work flow and data management are explored.

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Disclosures

Colin Movsowitz, MD is a consultant for Ambucor, a consultant and speaker for Biotronik and Boston Scientific, and a speaker for Medtronic and St. Jude Medical. Suneet Mittal, MD is a consultant for and EP fellowship training grant recipient from Biotronik, Boston Scientific, Medtronic and St. Jude Medical, and a speaker for Boston Scientific and Medtronic.

Both authors had full control of all primary data; we agree to allow the journal to review all data upon request.

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Authors and Affiliations

  1. Cardiology Consultants of Philadelphia, Lankenau Hospital, Wynnewood, PA, USA

    Colin Movsowitz

  2. The Al-Sabah Arrhythmia Institute and Division of Cardiology, The St. Luke’s and Roosevelt Hospitals, Columbia University College of Physicians and Surgeons, New York, NY, 10025, USA

    Suneet Mittal

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  1. Colin Movsowitz
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  2. Suneet Mittal
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Correspondence to Suneet Mittal.

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Movsowitz, C., Mittal, S. Remote patient management using implantable devices. J Interv Card Electrophysiol 31, 81–90 (2011). https://doi.org/10.1007/s10840-011-9548-2

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  • DOI: https://doi.org/10.1007/s10840-011-9548-2

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