title: Remote implantable cardioverter defibrillator monitoring in a Brugada syndrome population.
abstract: OBJECTIVE
  The diagnosis of Brugada syndrome (BS) is typically made in a young and otherwise healthy population. In patients with a high risk of sudden cardiac death (SCD), the only currently recommended therapy is an implantable cardioverter defibrillator (ICD), but these are not without complications. We investigated whether remote ICD monitoring could simplify follow-up and detect potential complications in these patients.
  
  
  RESULTS
  Thirty-five consecutive patients (26 males, 44 +/- 11 years) implanted with an ICD for BS with a remote monitoring ['Home Monitoring' (HM), Biotronik, Germany] system were prospectively enrolled in this study. They were matched for age, sex, and follow-up duration with 35 BS patients implanted with an ICD without this capability. During a mean follow-up of 33 +/- 17 months, the number of cardiology consultations was significantly lower in the HM group (3 +/- 2 vs. 7 +/- 3; P < 0.001). Inappropriate shock(s) [IS(s)] occurred in three patients (8.5%) in the HM group vs. six (17%) in the control group (P = NS). Ten patients in the HM group had a median of four alerts ('ventricular tachycardia/ventricular fibrillation detection' in all patients, 'shock' in three, 'ineffective shock' in two patients with shock on noise, 'extreme ventricular pacing impedance' in one patient due to lead failure, and 'deactivated therapy' in two patients with lead failure before replacement). In 5 of these 10 patients, prompt reprogramming of the ICD may have prevented IS(s).
  
  
  CONCLUSIONS
  Remote ICD monitoring in patients with BS decreases outpatient consultations and may help prevent ISs.
authors.affiliation: CHU de Bordeaux, Université Bordeaux II, France. frederic.sacher@chu-bordeaux.fr
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.forename: Vincent
authors.initials: V
authors.lastname: Probst
authors.forename: Maider
authors.initials: M
authors.lastname: Bessouet
authors.forename: Matthew
authors.initials: M
authors.lastname: Wright
authors.forename: Alexandre
authors.initials: A
authors.lastname: Maluski
authors.forename: Sélim
authors.initials: S
authors.lastname: Abbey
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordachar
authors.forename: Antoine
authors.initials: A
authors.lastname: Deplagne
authors.forename: Sylvain
authors.initials: S
authors.lastname: Ploux
authors.forename: Gilles
authors.initials: G
authors.lastname: Lande
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
authors.forename: Hervé
authors.initials: H
authors.lastname: Le Marec
authors.forename: Jacques
authors.initials: J
authors.lastname: Clémenty
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D053840:Brugada Syndrome / Q000503:physiopathology / Q000628:therapy*; D016022:Case-Control Studies; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac; D004868:Equipment Failure; D004869:Equipment Safety; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D011446:Prospective Studies; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000517:prevention & control*; D017216:Telemedicine / Q000379:methods*