Technician-Supported Remote Interrogation of CIEDs: Initial Use in US Emergency Departments and Perioperative Areas

Autor:	Amisha S. Patel, J B A Timothy Balgaard, Imdad Ahmed, Lynda E. Rosenfeld
Rok vydání:	2016
Předmět:	Presyncope business.industry Technician Retrospective cohort study General Medicine Perioperative Emergency department 030204 cardiovascular system & hematology medicine.disease Utilization review 03 medical and health sciences 0302 clinical medicine Perioperative care medicine In patient 030212 general & internal medicine Medical emergency Cardiology and Cardiovascular Medicine business
Zdroj:	Pacing and Clinical Electrophysiology. 39:275-281
ISSN:	0147-8389
Popis:	Background Interrogation/interpretation of cardiac implantable electronic devices (CIEDs) is frequently required in the emergency department (ED) or perioperative areas (OR) where resources to do this are often not available. CareLink Express (CLE; Medtronic, plc, Mounds View, MN, USA) is a technician-supported real-time remote interrogation system for Medtronic CIEDs. Using data from 136 US locations, this retrospective study was designed to assess CLE efficiency compared to traditional device management, and examine its findings. Methods All 7,044 US CLE transmissions from the ED and OR (January 2012–October 2014) were compared to 217 traditional requests where CIED interrogations/interpretations were performed by calling industry representatives to these sites. Results CLE reduced the time to device interrogation/interpretation by 78%: 100 ± 140–22 ± 14 minutes, P < 0.0001, improving response time and consistency; ED: 82 ± 103–23 ± 18 minutes, P, ≤ 0.01; OR: 127 ± 181–17 ± 10 minutes, P < 0.0001. Actionable events (AE) (arrhythmia, device/lead abnormalities) were infrequent: 9.1% overall (ED: 9.9%; OR: 4.1%). Only 6.5% of patients with syncope/presyncope and 13.6% with a perceived shock had AE. AEs were more common in those with suspected device problems (30.4%) or audible alerts (52.6%). They were more likely in patients not enrolled in long-term remote monitoring (23.9% vs 8.2%, P < 0.0001) and in those with older CIED systems (7.4% in year 1 vs 31.0% after 10 years). Conclusions The many patients with CIEDs, and the ability to quickly identify the minority with high-risk AE from the no/low-risk majority, strongly support CLE use in the ED and OR, sites which are expensive and prioritize efficiency.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::efbcd8ce5acb3661c5da4cbddda818ab https://doi.org/10.1111/pace.12798 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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