Department of Cardiology, Deutsches Kinderherzzentrum Sankt Augustin, Arnold Janssen Straße 29, D-53757 Sankt Augustin, Germany.
Europace. 2012 Jul;14(7):1030-7. doi: 10.1093/europace/eur434. Epub 2012 Feb 2.
In paediatric patients with a pacemaker (PM) or an implantable cardioverter defibrillator (ICD) device, interrogation during in-clinic visits is usually required to obtain information on arrhythmias or system failures. An automated telemonitoring system tracking patient- and system-related parameters provides this information on a daily basis and might assist patient management.
This retrospective analysis evaluates telemetric data obtained from 48 devices implanted in 45 patients (median age, 12.4 years; range, 5 weeks to 37.6 years) using an automated system [Home Monitoring (HM)] over the last 5 years. Regular transmissions were received on 72% of all days. The event messages and monitoring data of 34 (71%) devices induced system revisions, electrophysiological studies including ablation, programming changes, medication changes, and alterations in sporting activity. Approximately 47% of event messages and 50% of emergency messages arrived within 4 weeks of implantation or latest outpatient visit; 113 (17%) emergency messages reported acute changes in lead parameters or tachycardia, which required medical intervention. In four ICD patients, delivered shocks were unreported and only detected by HM.
An automated telemonitoring system reporting patient- and system-related parameters, generated within the patient's home surrounding, can improve the safety and quality of PM and ICD therapy, especially in children, by allowing early detection of system failure and changes in arrhythmic events.
在接受心脏起搏器 (PM) 或植入式心律转复除颤器 (ICD) 治疗的儿科患者中，通常需要在门诊就诊时进行设备检测，以获取心律失常或系统故障相关信息。患者相关参数和系统相关参数的自动远程监测系统可每天提供这些信息，有助于患者管理。
本回顾性分析评估了过去 5 年中，45 名患者（中位年龄 12.4 岁，范围为 5 周至 37.6 岁）的 48 台设备通过自动化系统[家庭监测 (HM)]获得的遥测数据。所有天数中，有 72%的天数可以定期接收传输数据。34 台（71%）设备的事件消息和监测数据引发了系统修订，包括电生理研究、消融术、程控更改、药物更改和运动活动改变。大约 47%的事件消息和 50%的紧急消息在植入或最近的门诊随访后 4 周内送达；113 份（17%）紧急消息报告了导联参数或心动过速的急性变化，需要医疗干预。在 4 名 ICD 患者中，除颤器放电未被报告，仅通过 HM 检测到。
报告患者相关参数和系统相关参数的自动远程监测系统，可在患者家庭环境中生成，通过早期发现系统故障和心律失常事件的变化，提高 PM 和 ICD 治疗的安全性和质量，尤其适用于儿童。
