Early Detection of Adverse Events with Daily Remote Monitoring versus Quarterly Standard Follow-Up Program in Patients with CRT-D

被引：16

作者：

De Ruvo, Ermenegildo ^{[1
]}

Gargaro, Alessio ^{[2
]}

Sciarra, Luigi ^{[1
]}

De Luca, Lucia ^{[1
]}

Zuccaro, Lorenzo Maria ^{[1
]}

Stirpe, Federica ^{[1
]}

Rebecchi, Marco ^{[1
]}

Sette, Antonella ^{[1
]}

Lioy, Ernesto ^{[1
]}

Calo, Leonardo ^{[1
]}

机构：

[1] UOC Cardiol, Policlin Casilino, ASL Roma B, Rome, Italy

[2] Biotron Italia Srl, Vimodrone, MI, Italy

来源：

PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2011年 / 34卷 / 02期

关键词：

CRT; ICD; remote monitoring; telemedicine; heart failure; RESYNCHRONIZATION THERAPY SYSTEMS; HEART-FAILURE; CARDIOVERTER-DEFIBRILLATORS; CLINICAL MANAGEMENT; CONSENSUS STATEMENT; ATRIAL-FIBRILLATION; IMPLANTED DEVICES; ICD; WIRELESS; ACCEPTANCE;

D O I：

10.1111/j.1540-8159.2010.02932.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Methods and Results: We retrospectively analyzed RM database and hospital files of 99 CRT-D consecutive patients who were visited in the out-patient clinic every 3-4 months; thirty-three patients were in addition controlled remotely with RM (RM group). Kaplan-Meier curves of clinical or device-related AE-free rates were obtained. During a median follow-up of 7 months, clinical AEs were: ventricular and atrial arrhythmias in 14 and 11 patients, low CRT pacing in nine, heart failure, strokes, or death in 15. Device-related AEs were: insufficient pacing/sensing performances in nine patients, lead dislodgement in five. As comparing the RM group with the remaining patients, Kaplan-Meier curves of clinical AEs diverged to significantly different rates: 23.8% (confidence interval [CI] 0.1%-47.5%) in the RM group and 48.7% (21.6-75.7%) in the remaining patients (P = 0.00002), with a hazard ratio of 0.14 (CI 0.06-0.37). Nondivergent Kaplan-Meier curves were obtained for device-related AE-free rates. Conclusion: CRT-D patients followed with quarterly in-office visits without a daily RM system had an 86% higher risk of delayed detection of clinical AEs, during a median follow-up of 7 months. (PACE 2011; 34:208-216).

引用

页码：208 / 216

页数：9

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