Assessment of a remote monitoring system for implantable cardioverter defibrillators.
We conducted a multicentre study in five Italian hospitals to assess the feasibility of a remote monitoring service for the follow-up of implanted cardiac devices. The system was designed to monitor device performance as well as physiological aspects of the patient's condition. Sixty-seven patients (mean age 64 years) affected by chronic heart failure and with a biventricular implantable cardioverter defibrillator for cardiac re-synchronization therapy (CRT-D) were enrolled for a three-month observation period. A total of 267 device recordings were transmitted through the ordinary telephone network, with a success rate of 99%. The telemonitoring service was more efficient than conventional face-to-face follow-up in terms of the time savings: both for physicians (4.7 minutes versus 15 minutes for remote and conventional monitoring) and for patients (6.6 minutes versus 116.3 minutes). In addition, a total of 23 clinical events occurred during the study, but only two cases required a clinic visit, thus reducing inappropriate hospital admissions. Finally, the service was well accepted by all the users.
Masella
Cristina
C
Department of Management, Economics and Industrial Engineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy.
Zanaboni
Paolo
P
Di Stasi
Francesca
F
Gilardi
Serena
S
Ponzi
Patrizia
P
Valsecchi
Sergio
S
D001145:Arrhythmias, Cardiac / Q000628:therapy*; D003362:Cost-Benefit Analysis; D017147:Defibrillators, Implantable; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000191:economics / Q000295:instrumentation*; D010349:Patient Compliance; D017060:Patient Satisfaction; D017216:Telemedicine / Q000191:economics / Q000379:methods*; D013689:Telephone / Q000295:instrumentation*; D016896:Treatment Outcome