Siebermair J, Clauss S, Martens E, Schuessler F, Oversohl N, Haserueck N, Estner H L, Kääb S, Wakili R
Department of Medicine I, Hospital of the Ludwig Maximilians University Munich (LMU), Ziemssenstr. 1, 80336, Munich, Germany.
Herz. 2015 Apr;40 Suppl 2:110-8. doi: 10.1007/s00059-014-4080-7. Epub 2014 May 23.
The rising number of implantable devices has led to an increase in device-related workload, e.g., regular interrogation follow-up visits. Telemonitoring systems for implantable cardioverter-defibrillators (ICDs) seem to be a promising tool for reducing workload and costs, and they have the potential of optimizing patient care. However, issues such as practical functionality of ICD telemonitoring in daily routine may affect its broad implementation. The objective of this study was to evaluate potential problems during the implementation of a telemonitoring system, Medtronic CareLink™ (CL™) with respect to the installation and data transmission process. A total of 159 patients with ICDs who were equipped with the CL™ system were evaluated and followed up for 16 months regarding the success rate of the first data transmission via the telemonitoring system. In this cohort, a high rate of nontransmission of 23.9 % was observed after the 16-month follow-up. A detailed interview of these patients (no transmission) revealed that the main reasons for failed transmissions were due to the patients' loss of interest in the concept (approximately 50 %) as well as technical problems (approximately 25 %) with setting up the system. These results indicate that telemonitoring systems bear potential problems and that the evaluation of patient motivation and technical support options seems to play an important role in establishing the functionality of these systems.
可植入设备数量的不断增加导致了与设备相关的工作量上升，例如定期的问询随访。植入式心脏复律除颤器（ICD）的远程监测系统似乎是减轻工作量和降低成本的一个有前景的工具，并且它们有优化患者护理的潜力。然而，ICD远程监测在日常实践中的实际功能等问题可能会影响其广泛应用。本研究的目的是评估远程监测系统美敦力CareLink™（CL™）在安装和数据传输过程中的潜在问题。共有159例配备了CL™系统的ICD患者接受了评估，并就通过远程监测系统首次数据传输的成功率进行了16个月的随访。在这个队列中，16个月随访后观察到23.9%的高未传输率。对这些未传输数据的患者进行详细访谈发现，传输失败的主要原因是患者对该概念失去兴趣（约50%）以及系统设置方面的技术问题（约25%）。这些结果表明，远程监测系统存在潜在问题，并且对患者动机和技术支持选项的评估似乎在建立这些系统的功能方面起着重要作用。
