Telecardiology and Remote Monitoring of Implanted Electrical Devices: The Potential for Fresh Clinical Care Perspectives

Telecardiology may help confront the growing burden of monitoring the reliability of implantable defibrillators/pacemakers. Herein, we suggest that the evolving capabilities of implanted devices to monitor patients’ status (heart rhythm, fluid overload, right ventricular pressure, oximetry, etc.) may imply a shift from strictly device-centered follow-up to perspectives centered on the patient (and patient-device interactions). Such approaches could provide improvements in health care delivery and clinical outcomes, especially in the field of heart failure. Major professional, policy, and ethical issues will have to be overcome to enable real-world implementation. This challenge may be relevant for the evolution of our health care systems.

[1]  L. Dreifus,et al.  Newer techniques in cardiac monitoring. , 1975, Heart & lung : the journal of critical care.

[2]  R. Wootton,et al.  Telemedicine in the National Health Service , 1998, Journal of the Royal Society of Medicine.

[3]  B Stanberry,et al.  Legal and ethical aspects of telemedicine , 1998, Journal of telemedicine and telecare.

[4]  R. Wootton,et al.  Recent advances: Telemedicine. , 2001, BMJ.

[5]  S Adler,et al.  Continuous ambulatory monitoring of absolute right ventricular pressure and mixed venous oxygen saturation in patients with heart failure using an implantable haemodynamic monitor: results of a 1 year multicentre feasibility study. , 2001, European heart journal.

[6]  R. Wootton,et al.  A review of guidelines and standards for telemedicine , 2002, Journal of telemedicine and telecare.

[7]  F. Braunschweig,et al.  Continuous Hemodynamic Monitoring in Heart Failure , 2002, Journal of cardiovascular electrophysiology.

[8]  A. Louis,et al.  A systematic review of telemonitoring for the management of heart failure , 2003, European journal of heart failure.

[9]  D. Theuns,et al.  Home monitoring in ICD therapy: future perspectives. , 2003, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[10]  R. Favaloro,et al.  Which Patients with Congestive Heart Failure May Benefit from Biventricular Pacing? , 2003, Pacing and clinical electrophysiology : PACE.

[11]  Carl May,et al.  Remote Doctors and Absent Patients: Acting at a Distance in Telemedicine? , 2003 .

[12]  G. Boriani,et al.  Cardioverter‐defibrillators after MADIT‐II: the balance between weight of evidence and treatment costs , 2003, European journal of heart failure.

[13]  M. Walsh,et al.  Randomized trial of a daily electronic home monitoring system in patients with advanced heart failure: the Weight Monitoring in Heart Failure (WHARF) trial. , 2003, American heart journal.

[14]  Manfred Zehender,et al.  Long-term survival after pacemaker implantation. Prognostic importance of gender and baseline patient characteristics. , 2004, European heart journal.

[15]  J. Burkhardt,et al.  Remote Interrogation and Monitoring of Implantable Cardioverter Defibrillators , 2004, Journal of Interventional Cardiac Electrophysiology.

[16]  Ruediger Becker,et al.  Patient alert in implantable cardioverter defibrillators: toy or tool? , 2004, Journal of the American College of Cardiology.

[17]  D. Weiss,et al.  Remote Monitoring of Implantable Cardioverter Defibrillators: , 2004, Pacing and clinical electrophysiology : PACE.

[18]  C. Morillo,et al.  The World Survey of Cardiac Pacing and Cardioverter Defibrillators: Calendar Year 2001 , 2004, Pacing and clinical electrophysiology : PACE.

[19]  G. Boriani,et al.  Cardiac resynchronization by pacing: an electrical treatment of heart failure. , 2004, International journal of cardiology.

[20]  Peter M Yellowlees,et al.  Successfully developing a telemedicine system. , 2005, Journal of telemedicine and telecare.

[21]  D. Reynolds,et al.  Sophisticated Remote Implantable Cardioverter‐Defibrillator Follow‐Up: A Status Report , 2005, Pacing and clinical electrophysiology : PACE.

[22]  A. Rigby,et al.  Noninvasive home telemonitoring for patients with heart failure at high risk of recurrent admission and death: the Trans-European Network-Home-Care Management System (TEN-HMS) study. , 2005, Journal of the American College of Cardiology.

[23]  Gerasimos Filippatos,et al.  Pathophysiologic targets in the early phase of acute heart failure syndromes. , 2005, The American journal of cardiology.

[24]  Michel Chauvin,et al.  Potential Cost Savings by Telemedicine‐Assisted Long‐Term Care of Implantable Cardioverter Defibrillator Recipients , 2005, Pacing and clinical electrophysiology : PACE.

[25]  C. Lau,et al.  Intrathoracic Impedance Monitoring in Patients With Heart Failure: Correlation With Fluid Status and Feasibility of Early Warning Preceding Hospitalization , 2005, Circulation.

[26]  E. Havranek,et al.  Improving the outcomes of heart failure care: putting technology second. , 2005, Journal of the American College of Cardiology.

[27]  G. Boriani,et al.  Role of ventricular Autocapture function in increasing longevity of DDDR pacemakers: a prospective study. , 2006, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[28]  R. Aguiar-Guevara M@TIC. Medicine Assisted by Information and Communication Technology: conflicts, responsibility and liability. , 2006, Medicine and law.

[29]  W. Maisel,et al.  Pacemaker and ICD generator malfunctions: analysis of Food and Drug Administration annual reports. , 2006, JAMA.

[30]  P. Brugada What evidence do we have to replace in-hospital implantable cardioverter defibrillator follow-up? , 2006, Clinical Research in Cardiology.

[31]  Richard Wootton,et al.  Realtime telemedicine. , 2006, Journal of telemedicine and telecare.

[32]  G. Boriani,et al.  Characteristics of ventricular tachyarrhythmias occurring in ischemic versus nonischemic patients implanted with a biventricular cardioverter-defibrillator for primary or secondary prevention of sudden death. , 2006, American heart journal.

[33]  S. Sack,et al.  Predicting mortality and rehospitalization in heart failure patients with Home Monitoring— , 2006, Clinical Research in Cardiology.

[34]  Dan M. Roden,et al.  ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines , 2006 .

[35]  H. Mond,et al.  The World Survey of Cardiac Pacingand Cardioverter‐Defibrillators: Calendar Year 2005 An International Cardiac Pacing andElectrophysiology Society (ICPES) project , 2008, Pacing and clinical electrophysiology : PACE.