Duncker David, Michalski Roman, Müller-Leisse Johanna, Zormpas Christos, König Thorben, Veltmann Christian
Rhythmologie und Elektrophysiologie, Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Herzschrittmacherther Elektrophysiol. 2017 Sep;28(3):268-278. doi: 10.1007/s00399-017-0521-3. Epub 2017 Aug 15.
Telemedicine is increasingly used in clinical cardiology. It offers early detection of arrhythmias, technical device follow-up and support of heart failure management. Regarding technical device follow-up, remote monitoring significantly reduces usage of the health care system. Furthermore, remote monitoring is associated with a significantly reduced time from device malfunction to physician's perception of the event. Using remote monitoring, inappropriate ICD (implantable cardioverter defibrillator) shocks can be significantly reduced compared to routine in-office follow-up. In retrospective studies and meta-analyses a prognostic benefit with respect to mortality has been shown. Device-based detection of atrial fibrillation and atrial high rate episodes is feasible. However, clinical relevance is currently studied in prospective randomized clinical trials. Heart failure management based on surrogate parameters has not been shown to significantly improve outcome. However, therapeutic management based on pulmonary artery pressure has been shown to significantly reduce morbidity and mortality. This review offers a comprehensive overview on the role of remote monitoring in heart failure management, technical device follow-up and detection of atrial fibrillation and atrial high rate episodes.
远程医疗在临床心脏病学中的应用日益广泛。它可实现心律失常的早期检测、技术设备的随访以及心力衰竭管理的支持。在技术设备随访方面，远程监测显著减少了医疗保健系统的使用。此外，远程监测与从设备故障到医生察觉该事件的时间显著缩短相关。与常规的门诊随访相比，使用远程监测可显著减少不适当的植入式心脏复律除颤器（ICD）电击次数。在回顾性研究和荟萃分析中，已显示出在死亡率方面的预后益处。基于设备检测心房颤动和心房高频率发作是可行的。然而，目前正在前瞻性随机临床试验中研究其临床相关性。基于替代参数的心力衰竭管理尚未显示能显著改善预后。然而，基于肺动脉压力的治疗管理已显示可显著降低发病率和死亡率。本综述全面概述了远程监测在心力衰竭管理、技术设备随访以及心房颤动和心房高频率发作检测中的作用。
