Automatic home monitoring of implantable cardioverter defibrillators.
OBJECTIVE
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.


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.


CONCLUSIONS
Home monitoring is feasible and associated with an early detection of medical and technical events.
Nielsen
Jens Cosedis
JC
Cardiology Department, Heart Center, University of Leipzig, Leipzig, Germany. cosedis@dadlnet.dk
Kottkamp
Hans
H
Zabel
Markus
M
Aliot
Etienne
E
Kreutzer
Ulrich
U
Bauer
Alexander
A
Schuchert
Andreas
A
Neuser
Hans
H
Schumacher
Burghard
B
Schmidinger
Herwig
H
Stix
Günter
G
Clémenty
Jacques
J
Danilovic
Dejan
D
Hindricks
Gerhard
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D017147:Defibrillators, Implantable; D019544:Equipment Failure Analysis / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017216:Telemedicine / Q000379:methods*; D013686:Telemetry / Q000379:methods*; D013813:Therapy, Computer-Assisted / Q000379:methods*