Remote Monitoring in Cardiac Resynchronization Therapy-First Experience in Romania with a CRT Virtual Ward.

Current health sciences journal Pub Date : 2023-04-01 Epub Date: 2023-06-30 DOI:10.12865/CHSJ.49.02.230
Emilia Violeta Goanță, Adrian Ungureanu, Georgică Târtea, Alexandra Murarețu, Diana Manciu, Cristina Văcărescu, Lucian Petrescu, Dragos Cozma
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Abstract

Background: Remote monitoring (RM) is becoming a standard of care for patients with cardiac resynchronization therapy (CRT). This technology combines the use of pacemakers or implantable cardioverter-defibrillators (ICD) and wireless communication to provide physicians with continuous, real-time information on the patient's cardiac activity. The purpose of the study was to evaluate if the remote monitoring technology in the follow-up CRT patients is feasible and safe.

Methods: A total of nine patients were enrolled in the study, implanted with a CRT system with wireless transmission capabilities. Immediately after the procedure received the RM, were enrolled in the virtual clinic and instructed by the doctor how to use the device at home. Regular virtual transmissions were made automatically every 3 weeks, respecting optimal transmission conditions. The accumulation of fluid in the lungs, atrial or ventricular tachyarrhythmia together with system integrity automatically activate alerts.

Results: One hundred and one transmissions were collected and analyzed from the virtual ward. Average follow-up was 7.7±4.8 months, longest follow-up was 18 months. None of the patients experienced complications during the study period, with three of them being follow-up solely through telemetric means by implanting physician. Treatment optimization was successfully conducted via phone consultations, when necessary, without any adverse events.

Conclusions: The results of our study suggest that RM could be integrated into routine CRT management protocols, enhancing patients care and resource utilization.

Abstract Image

Abstract Image

心脏再同步治疗的远程监测——罗马尼亚CRT虚拟病房的首次体验。
背景:远程监测(RM)正在成为心脏再同步治疗(CRT)患者的标准护理。这项技术结合了起搏器或植入式心律转复除颤器(ICD)的使用和无线通信,为医生提供关于患者心脏活动的连续实时信息。本研究的目的是评估远程监测技术在随访CRT患者中是否可行和安全。方法:共有9名患者被纳入研究,植入具有无线传输能力的CRT系统。手术收到RM后,立即进入虚拟诊所,并由医生指导如何在家使用该设备。根据最佳传输条件,每3周自动进行一次定期虚拟传输。肺部积液、心房或心室快速性心律失常以及系统完整性会自动激活警报。结果:从虚拟病房收集并分析了101个传输。平均随访7.7±4.8个月,最长随访18个月。在研究期间,没有一名患者出现并发症,其中三名患者仅通过植入医生的遥测手段进行随访。必要时通过电话咨询成功进行了治疗优化,没有出现任何不良事件。结论:我们的研究结果表明,RM可以整合到常规CRT管理方案中,提高患者护理和资源利用率。
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