Protocol-driven remote monitoring of cardiac resynchronization therapy as part of a heart failure disease management strategy
| Autor: | Pieter M. Vandervoort, Hélène De Cannière, Christophe J.P. Smeets, Lars Grieten, Inge M Thijs, Dorien Lanssens, Matthias Dupont, Jo Van der Auwera, Julie Vranken, Thijs Vandenberk, Frederik H. Verbrugge, Wilfried Mullens, Valerie Storms |
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| Přispěvatelé: | Clinical sciences, Medicine and Pharmacy academic/administration, Cardiology, Intensive Care |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors genetic structures medicine.medical_treatment Cardiac resynchronization therapy 030204 cardiovascular system & hematology Cardiac Resynchronization Therapy 03 medical and health sciences 0302 clinical medicine Clinical Protocols Internal medicine medicine Telemetry Cardiac Resynchronization Therapy/methods Humans Registries cardiovascular diseases 030212 general & internal medicine Disease management (health) Monitoring Physiologic Aged Heart Failure Protocol (science) Ejection fraction business.industry Follow up studies Disease Management General Medicine equipment and supplies medicine.disease Telemetry/methods Heart failure Monitoring Physiologic/methods Practice Guidelines as Topic Heart Failure/therapy cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies circulatory and respiratory physiology |
| Zdroj: | Acta Cardiologica. 73:230-239 |
| ISSN: | 0373-7934 0001-5385 |
| Popis: | BACKGROUND: Cardiac resynchronisation therapy (CRT) is an established treatment for heart failure (HF) with reduced ejection fraction. CRT devices are equipped with remote monitoring functions, which are pivotal in the detection of device problems, but may also facilitate disease management. The aim of this study was to provide a comprehensive overview of the clinical interventions taken based on remote monitoring. METHODS: This is a single centre observational study of consecutive CRT patients (n = 192) participating in protocol-driven remote follow-up. Incoming technical- and disease-related alerts were analysed together with subsequently triggered interventions. RESULTS: During 34 ± 13 months of follow-up, 1372 alert-containing notifications were received (2.53 per patient-year of follow-up), comprising 1696 unique alerts (3.12 per patient-year of follow-up). In 60%, notifications resulted in a phone contact. Technical alerts constituted 8% of incoming alerts (0.23 per patient-year of follow-up). Rhythm (1.43 per patient-year of follow-up) and bioimpedance alerts (0.98 per patient-year of follow-up) were the most frequent disease-related alerts. Notifications included a rhythm alert in 39%, which triggered referral to the emergency room (4%), outpatient cardiology clinic (36%) or general practitioner (7%), or resulted in medication changes (13%). Sole bioimpedance notifications resulted in a telephone contact in 91%, which triggered outpatient evaluation in 8% versus medication changes in 10%. Clinical outcome was excellent with 97% 1-year survival. CONCLUSIONS: Remote CRT follow-up resulted in 0.23 technical- versus 2.64 disease-related alerts annually. Rhythm and bioimpedance notifications constituted the majority of incoming notifications which triggered an actual intervention in 22% and 15% of cases, respectively. |
| Databáze: | OpenAIRE |
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