Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani, 2-35128 Padova, Italy.
Europace. 2011 Sep;13(9):1281-91. doi: 10.1093/europace/eur154. Epub 2011 Jun 3.
The remote monitoring of pacemakers and implantable cardioverter defibrillators (ICDs) promotes accurate supervision of the patient and device. Alert settings appear to be a crucial parameter of its efficacy. The purpose of our study was to evaluate various settings for alerts and alert message management in patients with pacemakers and ICDs.
We prospectively evaluated 282 patients (181 males, 101 females, mean age 72 ± 11 years) who were referred to nine electrophysiological centres in the Veneto region of Italy for a pacemaker (76 patients) or ICD (206 patients) implant in which remote monitoring was activated (Biotronik Home Monitoring®, Biotronik, Berlin, Germany). During a mean follow-up of 382 ± 261 days, we received 106,039 transmissions. In the pacemaker group, the alerts that were most frequently activated were those concerning battery exhaustion, surveying impedances, sensing and threshold measurements, as well as missing transmissions. In the ICD/ICD-cardiac resynchronization therapy group, the alerts nearly always activated were those concerning a detection setoff, battery exhaustion, critical values of impedance, or ineffective maximum energy shock. In both groups, the alarms for heart rate monitoring and supraventricular arrhythmia were activated in fewer cases at higher variability among centres.
Our study demonstrates that more attention is paid to critical technical data than to patients' clinical profiles, probably to limit an excessive flow of data into the centre. Accurate alert settings, personalized to the patients' features, are essential for easier and more effective management of patients who are followed remotely.
起搏器和植入式心律转复除颤器（ICD）的远程监测可促进对患者和设备的准确监测。报警设置似乎是其疗效的关键参数。本研究的目的是评估起搏器和 ICD 患者中各种报警设置和报警信息管理。
我们前瞻性评估了 282 名患者（181 名男性，101 名女性，平均年龄 72±11 岁），这些患者因在意大利威尼托地区的九个电生理中心植入起搏器（76 例）或 ICD（206 例）而被转诊，其中激活了远程监测（Biotronik Home Monitoring®，Biotronik，柏林，德国）。在平均 382±261 天的随访期间，我们收到了 106039 次传输。在起搏器组中，最常激活的报警是关于电池耗尽、探测阻抗、感知和阈值测量以及传输丢失的报警。在 ICD/ICD 心脏再同步治疗组中，几乎总是激活的报警是关于检测重置、电池耗尽、阻抗临界值或无效最大能量冲击的报警。在这两组中，心率监测和室上性心律失常的警报在中心之间的变异性较高的情况下，激活的情况较少。
我们的研究表明，与患者的临床特征相比，更多地关注临界技术数据，可能是为了限制数据过多流入中心。准确的报警设置，针对患者的特征进行个性化设置，对于更轻松、更有效地管理远程随访的患者至关重要。
