Usefulness of remote monitoring for the early detection of back-up mode in implantable cardioverter defibrillators.


Journal

Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655

Informations de publication

Date de publication:
Apr 2021
Historique:
received: 24 07 2020
revised: 07 08 2020
accepted: 30 11 2020
pubmed: 3 2 2021
medline: 2 6 2021
entrez: 2 2 2021
Statut: ppublish

Résumé

Reversion of an implantable cardioverter defibrillator (ICD) to back-up mode degrades the operating capabilities of the device, puts patients at risk and requires rapid intervention by a manufacturer's technician. To illustrate the usefulness of remote monitoring of ICDs for the early detection of reversion to back-up mode. In our centre, all patients implanted with an ICD, with or without resynchronisation, were offered remote monitoring as soon as the technology became available. Alerts triggered by the remote monitoring system were included prospectively in a register. During a mean follow-up of 5.7±1.3 years, a total of 1594 patients with an ICD (441 with resynchronisation function) followed with remote monitoring were included in the register. Among 15,874 alerts, only 10 were related to a reversion to back-up mode. Among those, seven reversions were caused by radiotherapy, two were fake events and one was caused by magnetic resonance imaging. Except for the two fake events, the eight other patients had an emergency admission for the resetting and reprogramming of their ICD. None of the reversion to back-up mode alerts was followed by a clinical alert (i.e. a shock alert) before the ICD problem was resolved. Reversion to back-up mode is a very rare event, accounting for 0.06% of total alerts; remote monitoring facilitates the early detection of this critical event to resolve the problem faster than the next scheduled follow-up. Remote monitoring can prevent serious damage to the patient and avoids systematic ambulatory control of the ICD after each radiotherapy session.

Sections du résumé

BACKGROUND BACKGROUND
Reversion of an implantable cardioverter defibrillator (ICD) to back-up mode degrades the operating capabilities of the device, puts patients at risk and requires rapid intervention by a manufacturer's technician.
AIM OBJECTIVE
To illustrate the usefulness of remote monitoring of ICDs for the early detection of reversion to back-up mode.
METHODS METHODS
In our centre, all patients implanted with an ICD, with or without resynchronisation, were offered remote monitoring as soon as the technology became available. Alerts triggered by the remote monitoring system were included prospectively in a register. During a mean follow-up of 5.7±1.3 years, a total of 1594 patients with an ICD (441 with resynchronisation function) followed with remote monitoring were included in the register.
RESULTS RESULTS
Among 15,874 alerts, only 10 were related to a reversion to back-up mode. Among those, seven reversions were caused by radiotherapy, two were fake events and one was caused by magnetic resonance imaging. Except for the two fake events, the eight other patients had an emergency admission for the resetting and reprogramming of their ICD. None of the reversion to back-up mode alerts was followed by a clinical alert (i.e. a shock alert) before the ICD problem was resolved.
CONCLUSIONS CONCLUSIONS
Reversion to back-up mode is a very rare event, accounting for 0.06% of total alerts; remote monitoring facilitates the early detection of this critical event to resolve the problem faster than the next scheduled follow-up. Remote monitoring can prevent serious damage to the patient and avoids systematic ambulatory control of the ICD after each radiotherapy session.

Identifiants

pubmed: 33526375
pii: S1875-2136(21)00012-7
doi: 10.1016/j.acvd.2020.11.008
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

287-292

Informations de copyright

Copyright © 2021 Elsevier Masson SAS. All rights reserved.

Auteurs

Laurence Guédon-Moreau (L)

Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France; Faculty of medicine, Lille university, 59045 Lille, France. Electronic address: laurence.guedon@chru-lille.fr.

Loïc Finat (L)

Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France.

Cédric Klein (C)

Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France.

Claude Kouakam (C)

Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France; Centre Oscar-Lambret, Cancer centre, 59000 Lille, France.

Christelle Marquié (C)

Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France.

Didier Klug (D)

Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France; Faculty of medicine, Lille university, 59045 Lille, France.

Charlotte Potelle (C)

Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France.

Sandro Ninni (S)

Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France; Faculty of medicine, Lille university, 59045 Lille, France.

François Brigadeau (F)

Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France.

Xavier Mirabel (X)

Centre Oscar-Lambret, Cancer centre, 59000 Lille, France.

Dominique Lacroix (D)

Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France; Faculty of medicine, Lille university, 59045 Lille, France.

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