Europace Advance Access published online on January 16, 2008
Europace, doi:10.1093/europace/eum289
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Home monitoring remote control of pacemaker and implantable cardioverter defibrillator patients in clinical practice: impact on medical management and health-care resource utilization
Department of Cardiovascular Disease, San Filippo Neri Hospital, Via Martinotti 20, 00135 Rome, Italy
Aims: To evaluate the impact of Home MonitoringTM(HM) remote control on patient medical treatment and on health-care resource utilization.
Methods and results: One hundred and seventeen patients received HM pacemakers or defibrillators. A pacing expert nurse consulted daily the website and submitted critical cases to physician. During a mean follow-up of 227 ± 128 days, 25 210 messages were received (23 545 daily messages and 1665 alert events) resulting in 90.7% of HM supervised days. Fifty-nine minutes/week for the nurse and 12 min/week for the physician were spent for HM data analysis during 267 web-connections. The mean connection time per patient was 115 ± 60 s. The nurse submitted to the physician 133 critical cases in 56 patients. The diagnosis were atrial fibrillation (47%), ventricular tachyarrhythmias (9%), inappropriate implantable cardioverter defibrillator intervention (4%), unsustained ventricular tachycardia (7%), device suboptimal programming (23%), and impending heart failure (10%). Sixty-six unplanned follow-up in 43 patients led to drug therapy change (44%), device reprogramming (18%), diagnosis confirmation without further intervention (24%), no confirmation (6%), further diagnostic tests (9%).
Conclusion: HM technology allowed optimization of medical treatment and device programming with low consumption of health-care resource.
Key Words: Home monitoring, Telecardiology, Atrial fibrillation, Ventricular tachyarrhythmias, Heart failure, Cardiac pacing
* Corresponding author. Tel: +39 06 3306 3934; fax: +39 06 3306 2489.E-mail address: renatopietroricci{at}tin.it
Manuscript submitted 18 September 2007. Accepted after revision 10 December 2007.
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