Dubner Sergio, Auricchio Angelo, Steinberg Jonathan S, Vardas Panos, Stone Peter, Brugada Josep, Piotrowicz Ryszard, Hayes David L, Kirchhof Paulus, Breithardt Günter, Zareba Wojciech, Schuger Claudio, Aktas Mehmet K, Chudzik Michal, Mittal Suneet, Varma Niraj
Clinica y Maternidad Suizo Argentina, Buenos Aires, Argentina.
Ann Noninvasive Electrocardiol. 2012 Jan;17(1):36-56. doi: 10.1111/j.1542-474X.2011.00484.x.
We are in the midst of a rapidly evolving era of technology-assisted medicine. The field of telemedicine provides the opportunity for highly individualized medical management in a way that has never been possible before. Evolving medical technologies using cardiac implantable devices with capabilities for remote monitoring permit evaluation of multiple parameters of cardiovascular physiology and risk, including cardiac rhythm, device function, blood pressure values, the presence of myocardial ischaemia, and the degree of compensation of congestive heart failure. Cardiac risk, device status, and response to therapies can now be assessed with these electronic systems of detection and reporting. This document reflects the extensive experience from investigators and innovators around the world who are shaping the evolution of this rapidly expanding field, focusing in particular on implantable pacemakers, implantable cardioverter defibrillators, devices for cardiac resynchronization therapy (both with and without defibrillation properties), loop recorders, and hemodynamic monitoring devices. This document covers the basic methodologies, guidelines for their use, experience with existing applications, and the legal and reimbursement aspects associated with their use. To adequately cover this important emerging topic, the International Society for Holter and Noninvasive Electrocardiology and the European Heart Rhythm Association combined their expertise in this field. We hope that the development of this field can contribute to improve care of our cardiovascular patients.
我们正处于技术辅助医学快速发展的时代。远程医疗领域以前所未有的方式提供了高度个性化医疗管理的机会。不断发展的医疗技术利用具有远程监测功能的心脏植入式设备,能够评估心血管生理和风险的多个参数,包括心律、设备功能、血压值、心肌缺血的存在以及充血性心力衰竭的代偿程度。现在可以通过这些检测和报告电子系统评估心脏风险、设备状态以及对治疗的反应。本文档反映了世界各地研究人员和创新者在塑造这个迅速扩展领域的发展过程中的丰富经验,特别关注植入式起搏器、植入式心脏复律除颤器、心脏再同步治疗设备(包括有和没有除颤功能的)、环路记录器以及血流动力学监测设备。本文档涵盖了基本方法、使用指南、现有应用的经验以及与它们使用相关的法律和报销方面。为了充分涵盖这个重要的新兴主题,动态心电图和无创心电学会国际协会与欧洲心律协会结合了他们在该领域的专业知识。我们希望这个领域的发展能够有助于改善我们心血管患者的护理。