Telemonitoring with implantable electronic devices in young patients with congenital heart diseases.
OBJECTIVE
In paediatric patients with a pacemaker (PM) or an implantable cardioverter defibrillator (ICD) device, interrogation during in-clinic visits is usually required to obtain information on arrhythmias or system failures. An automated telemonitoring system tracking patient- and system-related parameters provides this information on a daily basis and might assist patient management.


RESULTS
This retrospective analysis evaluates telemetric data obtained from 48 devices implanted in 45 patients (median age, 12.4 years; range, 5 weeks to 37.6 years) using an automated system [Home Monitoring (HM)] over the last 5 years. Regular transmissions were received on 72% of all days. The event messages and monitoring data of 34 (71%) devices induced system revisions, electrophysiological studies including ablation, programming changes, medication changes, and alterations in sporting activity. Approximately 47% of event messages and 50% of emergency messages arrived within 4 weeks of implantation or latest outpatient visit; 113 (17%) emergency messages reported acute changes in lead parameters or tachycardia, which required medical intervention. In four ICD patients, delivered shocks were unreported and only detected by HM.


CONCLUSIONS
An automated telemonitoring system reporting patient- and system-related parameters, generated within the patient's home surrounding, can improve the safety and quality of PM and ICD therapy, especially in children, by allowing early detection of system failure and changes in arrhythmic events.
Department of Cardiology, Deutsches Kinderherzzentrum Sankt Augustin, Arnold Janssen Straße 29, D-53757 Sankt Augustin, Germany. p.zartner@asklepios.com
Peter A
PA
Zartner
Nicole
N
Toussaint-Goetz
Joachim
J
Photiadis
Walter
W
Wiebe
Martin B
MB
Schneider
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D017147:Defibrillators, Implantable; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital; D006801:Humans; D007223:Infant; D008297:Male; D010138:Pacemaker, Artificial; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult