title: Results of remote follow-up and monitoring in young patients with cardiac implantable electronic devices.
abstract: BACKGROUND
  Remote monitoring is increasingly used in the follow-up of patients with cardiac implantable electronic devices. Data on paediatric populations are still lacking. The aim of our study was to follow-up young patients both in-hospital and remotely to enhance device surveillance.
  
  
  METHODS
  This is an observational registry collecting data on consecutive patients followed-up with the CareLink system. Inclusion criteria were a Medtronic device implanted and patient's willingness to receive CareLink. Patients were stratified according to age and presence of congenital/structural heart defects (CHD).
  
  
  RESULTS
  A total of 221 patients with a device - 200 pacemakers, 19 implantable cardioverter defibrillators, and two loop recorders--were enrolled (median age of 17 years, range 1-40); 58% of patients were younger than 18 years of age and 73% had CHD. During a follow-up of 12 months (range 4-18), 1361 transmissions (8.9% unscheduled) were reviewed by technicians. Time for review was 6 ± 2 minutes (mean ± standard deviation). Missed transmissions were 10.1%. Events were documented in 45% of transmissions, with 2.7% yellow alerts and 0.6% red alerts sent by wireless devices. No significant differences were found in transmission results according to age or presence of CHD. Physicians reviewed 6.3% of transmissions, 29 patients were contacted by phone, and 12 patients underwent unscheduled in-hospital visits. The event recognition with remote monitoring occurred 76 days (range 16-150) earlier than the next scheduled in-office follow-up.
  
  
  CONCLUSIONS
  Remote follow-up/monitoring with the CareLink system is useful to enhance device surveillance in young patients. The majority of events were not clinically relevant, and the remaining led to timely management of problems.
authors.affiliation: Arrhythmia Unit and Syncope Unit,Department of Paediatric Cardiology and Cardiac Surgery,Bambino Gesù Children's Hospital,Rome,Italy.
authors.forename: Massimo S
authors.initials: MS
authors.lastname: Silvetti
authors.affiliation: Arrhythmia Unit and Syncope Unit,Department of Paediatric Cardiology and Cardiac Surgery,Bambino Gesù Children's Hospital,Rome,Italy.
authors.forename: Fabio A
authors.initials: FA
authors.lastname: Saputo
authors.affiliation: Arrhythmia Unit and Syncope Unit,Department of Paediatric Cardiology and Cardiac Surgery,Bambino Gesù Children's Hospital,Rome,Italy.
authors.forename: Rosalinda
authors.initials: R
authors.lastname: Palmieri
authors.affiliation: Arrhythmia Unit and Syncope Unit,Department of Paediatric Cardiology and Cardiac Surgery,Bambino Gesù Children's Hospital,Rome,Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Placidi
authors.affiliation: Arrhythmia Unit and Syncope Unit,Department of Paediatric Cardiology and Cardiac Surgery,Bambino Gesù Children's Hospital,Rome,Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Santucci
authors.affiliation: Arrhythmia Unit and Syncope Unit,Department of Paediatric Cardiology and Cardiac Surgery,Bambino Gesù Children's Hospital,Rome,Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Di Mambro
authors.affiliation: Arrhythmia Unit and Syncope Unit,Department of Paediatric Cardiology and Cardiac Surgery,Bambino Gesù Children's Hospital,Rome,Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Righi
authors.affiliation: Arrhythmia Unit and Syncope Unit,Department of Paediatric Cardiology and Cardiac Surgery,Bambino Gesù Children's Hospital,Rome,Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Drago
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D018670:Monitoring, Ambulatory / Q000379:methods; D010138:Pacemaker, Artificial; D017216:Telemedicine; D055815:Young Adult
keywords: Pacemaker; children; implantable cardiac device; implantable cardioverter defibrillator; pacing complication; trans-telephonic monitoring