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Title: | Protocol-driven remote monitoring of cardiac resynchronization therapy as part of a heart failure disease management strategy | Authors: | SMEETS, Christophe VERBRUGGE, Frederik VRANKEN, Julie Van der Auwera, Jo MULLENS, Wilfried DUPONT, Matthias GRIETEN, Lars DE CANNIERE, Helene LANSSENS, Dorien VANDENBERK, Thijs STORMS, Valerie THIJS, Inge VANDERVOORT, Pieter |
Issue Date: | 2017 | Publisher: | TAYLOR & FRANCIS LTD | Source: | ACTA CARDIOLOGICA, 73(3), p. 230-239 | Abstract: | Background: Cardiac resynchronisation therapy (CRT) is an established treatment for heart failure (HF) with reduced ejection fraction. CRT devices are equipped with remote monitoring functions, which are pivotal in the detection of device problems, but may also facilitate disease management. The aim of this study was to provide a comprehensive overview of the clinical interventions taken based on remote monitoring. Methods: This is a single centre observational study of consecutive CRT patients (n=192) participating in protocol-driven remote follow-up. Incoming technical- and disease-related alerts were analysed together with subsequently triggered interventions. Results: During 3413 months of follow-up, 1372 alert-containing notifications were received (2.53 per patient-year of follow-up), comprising 1696 unique alerts (3.12 per patient-year of follow-up). In 60%, notifications resulted in a phone contact. Technical alerts constituted 8% of incoming alerts (0.23 per patient-year of follow-up). Rhythm (1.43 per patient-year of follow-up) and bioimpedance alerts (0.98 per patient-year of follow-up) were the most frequent disease-related alerts. Notifications included a rhythm alert in 39%, which triggered referral to the emergency room (4%), outpatient cardiology clinic (36%) or general practitioner (7%), or resulted in medication changes (13%). Sole bioimpedance notifications resulted in a telephone contact in 91%, which triggered outpatient evaluation in 8% versus medication changes in 10%. Clinical outcome was excellent with 97% 1-year survival. Conclusions: Remote CRT follow-up resulted in 0.23 technical- versus 2.64 disease-related alerts annually. Rhythm and bioimpedance notifications constituted the majority of incoming notifications which triggered an actual intervention in 22% and 15% of cases, respectively. | Notes: | [Smeets, Christophe J. P.; Verbrugge, Frederik H.; Van der Auwera, Jo; Mullens, Wilfried; Dupont, Matthias; De Canniere, Helene; Vandervoort, Pieter] Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. [Smeets, Christophe J. P.; Vranken, Julie; Van der Auwera, Jo; Grieten, Lars; De Canniere, Helene; Lanssens, Dorien; Vandenberk, Thijs; Storms, Valerie; Thijs, Inge M.; Vandervoort, Pieter] Hasselt Univ, Fac Med & Life Sci, Mobile Hlth Unit, Hasselt, Belgium. [Smeets, Christophe J. P.; Vranken, Julie; De Canniere, Helene; Lanssens, Dorien; Vandenberk, Thijs; Thijs, Inge M.; Vandervoort, Pieter] Ziekenhuis Oost Limburg, Dept Future Hlth, Genk, Belgium. | Keywords: | Heart failure;cardiac resynchronisation therapy;remote monitoring;disease management;clinical call centre | Document URI: | http://hdl.handle.net/1942/28515 | ISSN: | 0001-5385 | e-ISSN: | 1784-973X | DOI: | 10.1080/00015385.2017.1363022 | ISI #: | 000435000800003 | Rights: | Belgian Society of Cardiology | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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