Performance of an autonomous telemonitoring system in children and young adults with congenital heart diseases.
BACKGROUND
Integrated telemonitoring systems controlling circulatory and electrical parameters in adults with an implanted pacemaker have shown to be advantageous during follow-up of this patient group. In children and young adults with a congenital heart disease (CHD), these systems have to cope with a diversity of varying arrhythmias and a broad range of intrinsic cardiac parameters. Additional problems arise from the patients' growth and anatomic anomalies.


METHODS
Since 2005, eight young patients (age 4.1- 37 years, mean 15.5 years) with a CHD received a pacemaker or implantable cardioverter defibrillator with an autonomous telemonitoring system at our clinic. The mean follow-up time was 395 days (range 106-834 days, 8.7 patient years).


RESULTS
In seven of eight patients the system transmitted information, which led to beneficial modifications of the current antiarrhythmic therapy. In three patients the reported events were of a critical nature. One patient remained event-free for 192 days after implantation. During follow-up, 96% of the days were covered. The system also transferred additional information on the effectiveness of antiarrhythmic medication and the impact of physical activity.


CONCLUSIONS
Young patients with an insufficient intrinsic heart rate or progressing arrhythmia, in addition to the conventional indications for pacemaker or defibrillator implantation, seem to profit to a high percentage from a telemetric surveillance system. The fully automated procedure of device interrogation and information transmission gives a daily overview on system function and specific arrhythmic events, especially in children who are unaware of any symptoms.
Zartner
Peter
P
Department of Cardiology, German Pediatric Heart Centre, Sankt Augustin, Germany. p.zartner@asklepios.com
Handke
Ronald
R
Photiadis
Joachim
J
Brecher
Anne M
AM
Schneider
Martin B
MB
D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial; D002648:Child; D002675:Child, Preschool; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D008297:Male; D019114:Remote Consultation / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult