Frequency and Characteristics of Remote Monitoring Detected Event
Notifications in a Population with Cardiac Implantable Electronic
Devices
Pedro Silva Cunha, Mário Martins Oliveira, Manuel Nogueira da Silva, Joana Feliciano,
Sandra Alves, Ricardo Pimenta, Sofia Almeida Santos and Rui Cruz Ferreira
Santa Marta Hospital, Cardiology Service, Rua de Santa Marta nº 50, 1169-024 Lisboa, Portugal
Keywords: Remote Monitoring, Cardiac Implantable Electronic Devices.
Abstract: Current remote monitoring technology allows permanent follow-up of cardiac implantable electronic
devices. However, the long term frequency and characteristics of event notifications are unknown. We
reviewed the data base from our population who received an ICD and were followed by using a remote
monitoring system and focus was placed on event notifications, characterized as either related to therapy
delivery or to others reasons.
1 INTRODUCTION
Evidence-based expansion of indications for cardiac
implantable electronic devices has led to a dramatic
increase in the number of implants in the last
decade.
Current remote monitoring technology allows
permanent follow-up of cardiac implantable
electronic devices.
Home Monitoring system of implanted
pacemakers and ICDs was first introduced in
Europe in the year in 2000. Since the first clinical
study, feasibility and technical reliability of this
remote monitoring systems were clearly shown.
However, the long term frequency and
characteristics of event notifications are unknown.
Moreover, this information is critical for the
development of infrastructures to successfully
execute a continuous remote monitoring program.
2 METHODS
We reviewed the data base from our population who
received an implantable cardioverter defibrillator
(ICD) and were followed for > 3 months by using a
remote monitoring system. A total of 276 patients
were included, and focus was placed on event
notifications, characterized as either related to
therapy delivery (ATP or ICD shocks) or to others
reasons (heart failure, battery status, atrial
fibrillation, lead failure, untreated sustained
ventricular arrhythmia).
Of this 276 (75% men; 60.4±14.6 years) with an
ICD (n=197; 21% dual-chamber) or an ICD
combined with a cardiac resynchronization therapy
device (n=79).
Cardiac implantable electronic devices were
implanted for primary prevention of sudden death in
172 cases and for secondary prevention in 104 cases.
Data was incorporated into the hospital
information system via web and analyzed by an
allied professional and an electrophysiologist in a
single center follow-up program.
3 RESULTS
During a mean follow-up of 32 months, a total of
9996 alerts were recorded, corresponding to 1134
episodes (11,3%) of therapy delivery (1020 ATP and
114 shocks) and 8862 alerts (88,6%) related to other
reasons.
There were problems in the data transmission of
22 alert episodes (0,25% of all alerts).
Silva Cunha P., Martins Oliveira M., Nogueira da Silva M., Feliciano J., Alves S., Pimenta R., Almeida Santos S. and Ferreira R..
Frequency and Characteristics of Remote Monitoring Detected Event Notifications in a Population with Cardiac Implantable Electronic Devices.
Copyright
c
 2013 SCITEPRESS (Science and Technology Publications, Lda.)

4 CONCLUSIONS
Although representing the minority of all alerts,
episodes of ventricular tachyarrhythmias treated via
ICD represent an important clinical situation, since a
delay in the analysis of this information may have
impact in patient care.
The centers following cardiac implantable
electronic devices in a remote program, need to
establish an infrastructure and strategy to manage
these alerts, which represents a real challenge in
clinical practice, as the burden of remotely produced
data continues to increase
.
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