Automatic home monitoring of implantable cardioverter defibrillators

作者：Nielsen Jens Cosedis^*; Kottkamp Hans; Zabel Markus; Aliot Etienne; Kreutzer Ulrich; Bauer Alexander; Schuchert Andreas; Neuser Hans; Schumacher Burghard; Schmidinger Herwig; Stix Guenter; Clementy Jacques; Danilovic Dejan; Hindricks Gerhard

来源：Europace, 2008, 10(6): 729-735.

DOI：10.1093/europace/eun099

• implantable cardioverter defibrillator
• fibrillation
• defibrillation
• tachycardia
• follow-up
• home monitoring

Aims With the expanding indications for implantable cardioverter defibrillator (ICD) and reports of unexpected ICD failures, home monitoring (HM) was proposed to decrease follow-up workload and increase patient safety. Home monitoring implantable cardioverter defibrillators offer wireless, everyday transfer of ICD status and therapy data to a central HM Service Center, which notifies the attending physician of relevant HM events. We evaluated functionality and safety of HM ICDs.
Methods and results A total of 260 patients with HM ICDs were monitored for a mean of 10 +/- 5 months. Time to HM events [medical (ventricular tachycardia/ventricular fibrillation) and technical (ICD system integrity)] since ICD implantation and since the latest in-clinic follow-up was analysed. Mean number of HM events per 100 patients per day was calculated, without and with a 2-day blanking period for re-notifying the same type of event. About 41.2% of the patients had HM events (38.1% medical, 0.8% technical, and 2.3% both types). Probability of any HM event after 1.5 years was 0.50 (95% confidence interval: 0.42-0.58). More than 60% of new HM event types occurred within the first month after follow-up. A mean of 0.86 event notifications was received per 100 patients per day or 0.45 with the 2-day blanking period.
Conclusion Home monitoring is feasible and associated with an early detection of medical and technical events.

• 出版日期2008-6
• 单位河南工业大学