植入式心脏复律除颤器患者的远程监测：一种安全、省时且经济高效的随访方式。

Remote monitoring of implantable cardioverter defibrillator patients: a safe, time-saving, and cost-effective means for follow-up.

作者信息

Raatikainen M J Pekka, Uusimaa Paavo, van Ginneken Mireille M E, Janssen Jacques P G, Linnaluoto Markku

机构信息

Division of Cardiology, Department of Internal Medicine, University of Oulu, PO Box 5000, 90014 Oulu, Finland.

出版信息

Europace. 2008 Oct;10(10):1145-51. doi: 10.1093/europace/eun203. Epub 2008 Aug 14.

AIMS

The purpose of this prospective study was to investigate whether internet-based remote monitoring offers a safe, practical, and cost-effective alternative to the in-office follow-up visits of patients with an implantable cardioverter defibrillator (ICD).

METHODS AND RESULTS

Forty-one patients (62 +/- 10 years, range 41-76, 83% male) with previously implanted ICD were followed for 9 months. One-hundred and nineteen scheduled and 18 unscheduled data transmissions were performed. There were no device-related adverse events. Over 90% of the patients found the system easy to use. Physicians reported the system as being 'very easy' or 'easy' to use and found the data comparable to traditional device interrogation in 99% of the cases. They were able to address all unscheduled data transmissions remotely. Compared with the in-office visits, remote monitoring required less time from patients (6.9 +/- 5.0 vs. 182 +/- 148 min, P < 0.001) and physicians (8.4 +/- 4.5 vs. 25.8 +/- 17.0 min, P < 0.001) to complete the follow-up. Substitution of two routine in-office visits during the study by remote monitoring reduced the overall cost of routine ICD follow-up by 524 euro per patient (41%).

CONCLUSION

Remote monitoring offers a safe, feasible, time-saving, and cost-effective solution to ICD follow-up.

目的

本前瞻性研究旨在调查基于互联网的远程监测对于植入式心脏复律除颤器（ICD）患者的门诊随访而言，是否提供了一种安全、实用且具成本效益的替代方案。

方法与结果

41例先前已植入ICD的患者（年龄62±10岁，范围41 - 76岁，83%为男性）接受了9个月的随访。进行了119次定期和18次不定期的数据传输。未发生与设备相关的不良事件。超过90%的患者认为该系统易于使用。医生报告该系统“非常容易”或“容易”使用，并发现99%的病例中数据与传统设备问询相当。他们能够远程处理所有不定期的数据传输。与门诊就诊相比，远程监测完成随访所需的患者时间更少（6.9±5.0分钟对182±148分钟，P<0.001），医生时间也更少（8.4±4.5分钟对25.8±17.0分钟，P<0.001）。在研究期间，通过远程监测替代两次常规门诊就诊，使每位患者的ICD常规随访总成本降低了524欧元（41%）。