Remote monitoring of patients with cardiac implantable electronic devices: a Southeast Asian, single-centre pilot study
Remote monitoring of patients with cardiac implantable electronic devices: a Southeast Asian, single-centre pilot study
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DOI：
10.11622/smedj.2016120
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发表时间：
2016-07-01
影响因子：
2.7
通讯作者：
Ching, Chi Keong
中科院分区：
文献类型：
--
作者：
Lim, Paul Chun Yih;Lee, Audry Shan Yin;Ching, Chi Keong
引言心脏植入式电子设备（CIED）的远程监测已被证明可以提高患者安全性并减少门诊。我们报告我们的经验与远程监控通过美敦力CareLink（R）network.METHODS患者进行了为期六个月的随访，除了例行的办公室检查每月远程监控传输。通过记录传输依从性、需要干预的器械警报数量以及从传输到审查的时间来评价远程监测的有效性。结果共纳入57例患者，其中永久起搏器16例（28.1%），植入心律转复除颤器34例（59.6%），心脏起搏治疗除颤器7例（12.3%）。总的来说，在334次预定的远程传输中，73.7%准时，14.5%逾期，11.8%错过。84.6%的无线传输是准时的，而非无线传输是53.8%。在所有传输中，4.4%包含通知医生的警报，只有1.8%需要干预。98.6%的远程传输在第二个工作日内得到审查。73.2%的患者倾向于远程监护。医生们一致认为，远程传输提供的信息相当于97.1%的办公室检查。77.8%的医技人员认为远程监护有助于医院提高患者管理水平。结论远程监测CIED是安全可行的。通过早期检测心律失常或器械故障，允许早期干预，可能有利于患者安全。特别地，无线远程监测可以改善对设备监测的依从性。由于可能改善生活质量，患者可能更喜欢远程监测。
INTRODUCTION Remote monitoring of cardiac implantable electronic devices (CIED) has been shown to improve patient safety and reduce in-office visits. We report our experience with remote monitoring via the Medtronic CareLink (R) network.METHODS Patients were followed up for six months with scheduled monthly remote monitoring transmissions in addition to routine in-office checks. The efficacy of remote monitoring was evaluated by recording compliance to transmissions, number of device alerts requiring intervention and time from transmission to review. Questionnaires were administered to evaluate the experiences of patients, physicians and medical technicians.RESULTS A total of 57 patients were enrolled; 16 (28.1%) had permanent pacemakers, 34 (59.6%) had implantable cardioverter defibrillators and 7 (12.3%) had cardiac resynchronisation therapy defibrillators. Overall, of 334 remote transmissions scheduled, 73.7% were on time, 14.5% were overdue and 11.8% were missed. 84.6% of wireless transmissions were on time, compared to 53.8% of non-wireless transmissions. Among all transmissions, 4.4% contained alerts for which physicians were informed and only 1.8% required intervention. 98.6% of remote transmissions were reviewed by the second working day. 73.2% of patients preferred remote monitoring. Physicians agreed that remote transmissions provided information equivalent to in-office checks 97.1% of the time. 77.8% of medical technicians felt that remote monitoring would help the hospital improve patient management. No adverse events were reported.CONCLUSION Remote monitoring of CIED is safe and feasible. It has possible benefits to patient safety through earlier detection of arrhythmias or device malfunction, permitting earlier intervention. Wireless remote monitoring, in particular, may improve compliance to device monitoring. Patients may prefer remote monitoring due to possible improvements in quality of life.