HRS/EHRA Expert Consensus on the Monitoring of Cardiovascular Implantable Electronic Devices (CIEDs): description of techniques, indications, personnel, frequency and ethical considerations: developed in partnership with the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA); and in collaboration with the American College of Cardiology (ACC), the American Heart Association (AHA), the European Society of Cardiology (ESC), the Heart Failure Association of ESC (HFA), and th
"Follow-ups were left to the physician's discretion, although they had to comply with the Expert Consensus on the Monitoring of Cardiovascular Implantable Electronic Devices (i.e. face-toface visits within 72 hours and between two and 12 weeks after device implantation, and every 3—6 months thereafter, either face-to-face or remotely) . "
[Show abstract][Hide abstract] ABSTRACT: Background. - Much attention is being paid to the education of and provision of medical information to patients, to optimize their understanding and acceptance of their disease. Aims. - To ascertain the impact of educating recent recipients of an implantable cardioverter defibrillator (ICD) on their perception and acceptance of a home monitoring (HM) system. Methods. - Questionnaire 1, completed one month after ICD implantation, was designed to assess: the quality of patient preparation for HM; patient comprehension of HM; and patient anxiety experienced during its installation. The comprehension questions were assigned a score of 2 for an incorrect answer, +1 for a correct answer and 0 for neither (total score ranging from 40 to +20). Questionnaire 2, completed six months after ICD implantation, assessed patient acceptance of and anxiety about HM. Results. - The registry included 571 patients (mean age 63.9 +/- 12.8 years; 83% men; 76% of ICDs implanted for primary prevention) followed by HM for 6.2 +/- 1.2 months. Questionnaire 1 was completed by 430 (75.3%) patients and questionnaire 2 by 398 (69.7%) patients. Younger patients had a better comprehension of HM than older patients. High-quality training conditions improved the comprehension score, and a positive association was observed between anxiety and acceptance levels and the comprehension score. The 80 +/- 20% mean data transmission rate (days of transmission/days of follow-up ratio) was unrelated to the comprehension scores. Conclusion. - A clear understanding was associated with a higher acceptance of HM, although it was unrelated to the data transmission rate.
[Show abstract][Hide abstract] ABSTRACT: Unlike the standard quarterly or semi-annual direct ambulatory device interrogations procedures, state-of-the-art implantable electronic cardiovascular devices (IECD) enable their wireless remote interrogation and monitoring, and automatically send reports and special alerts on a daily basis. This allows physicians to respond more proactively to changes in patient or device status, more appropriately triage patient care, and more efficiently perform the post-implant ambulatory follow-ups. This review presents the-state-of the-art technology of remote IECD monitoring and summarizes the main clinical observations published through June 2008. Cardiovascular remote monitoring systems made by several manufacturers are currently in various phases of development, clinical investigation, and medical applications. Data collected in several completed and ongoing studies strongly suggest that this new technology will make important contributions, particularly with respect to the facilitation of IECD follow-ups, enhancement of patient safety and quality of life, and lowering of medical costs. Further technological advances and a more clear understanding and appreciation of the clinical and economic benefits of telecardiology, will likely increase sharply the use of remote IECD monitoring in upcoming years.
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