title: ICD function and dysfunction in patients with arrhythmogenic cardiac diseases: the role of home monitoring.
abstract: BACKGROUND
  Since their implementation in clinical practice, remote home monitoring systems (HM) have undoubtedly become an added value in patients with implantable devices for cardiac rhythm management. The aim of this study was to investigate the impact of HM on clinical management and outcome in patients with channelopathies and other arrhythmogenic diseases who received an implantable cardioverter defibrillator (ICD).
  
  
  METHODS
  Fifty-four patients (age 6 months--74 years) were followed by means of HM in our ICD clinic. Alerts and/or device-related clinical events were analysed in all patients and subsequent clinical decisions were made if indicated.
  
  
  RESULTS
  During an average observation time of 27 months, 46 alerts were received from 32 different patients. Five patients (9%) received appropriate therapies for life-threatening arrhythmias and four patients (8%) inappropriate therapies because ofT wave oversensing or supraventricular tachycardias. Three patients had alerts due to electrical noise (two on the atrial, one on the ventricular channel). Overall, 18 alerts (39%) required a modification of the pharmacological therapy or the programming of the device. Mean anticipation of clinical visits based on the alerts was 92.6 +/- 56 days (median 97, interquartile range 50-150).
  
  
  CONCLUSIONS
  HM substantially improves the clinical management of patients with cardiac arrhythmogenic disease by early recognition of device-related inappropriate therapies and subsequent anticipation of treatment adaptation.
authors.affiliation: Cardiovascular Division and Heart Rhythm Management Center, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. carlodeasmundis@me.com
authors.forename: Carlo
authors.initials: C
authors.lastname: De Asmundis
authors.forename: Danilo
authors.initials: D
authors.lastname: Ricciardi
authors.forename: Mehdi
authors.initials: M
authors.lastname: Namdar
authors.forename: Gudrun
authors.initials: G
authors.lastname: Pappaert
authors.forename: Moises
authors.initials: M
authors.lastname: Rodríguez-Mañero
authors.forename: Kristel
authors.initials: K
authors.lastname: Wauters
authors.forename: Ruben
authors.initials: R
authors.lastname: Casado-Arroyo
authors.forename: Jayakeerthi J
authors.initials: JJ
authors.lastname: Rao
authors.forename: Fatih
authors.initials: F
authors.lastname: Bayrak
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.forename: Andrea
authors.initials: A
authors.lastname: Sarkozy
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D001530:Belgium; D017147:Defibrillators, Implantable; D042241:Early Diagnosis; D015716:Electrocardiography, Ambulatory / Q000009:adverse effects / Q000379:methods; D022062:Electrophysiologic Techniques, Cardiac / Q000009:adverse effects / Q000379:methods; D019544:Equipment Failure Analysis / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019114:Remote Consultation / Q000379:methods*; D016896:Treatment Outcome