Pulickal Tobyson, Helms Thomas M, Perings Christian A
Katholisches Klinikum Lünen / Werne St.-Marien-Hospital Lünen, Medizinische Klinik 1, Lünen, Deutschland.
Deutsche Stiftung für chronisch Kranke, Fürth, Deutschland.
Herzschrittmacherther Elektrophysiol. 2021 Jun;32(2):264-268. doi: 10.1007/s00399-021-00769-0. Epub 2021 May 12.
Telemedical care can point out new applications of already established therapeutics such as a wearable cardioverter-defibrillator (WCD) and improve the quality of care for chronically ill patients with heart failure through improved management of data derived from this device. The current case report describes the clinical course of a 71-year-old man, who was treated with a WCD in accordance with the current guidelines until a final decision was made about ICD implantation, after acute cardiac decompensation and lately diagnosed severe decrease of left ventricular function in the context of ischaemic cardiomyopathy. The data collected by the WCD were evaluated in a structured way via a telemedicine centre (TMC) and recurrence of the previously known paroxysmal atrial fibrillation (AF) was discovered. This made it possible to treat the paroxysmal AF, before cardiac decompensation happened again by adjusting the medication and early initiation of pulmonary vein isolation (PVI). This case exemplifies the usefulness of structured telemedical intervention, which makes it possible to meaningfully supplement established concepts of patient care, improve existing concepts and significantly improve patient care.
远程医疗护理可以指出已有的治疗方法（如可穿戴式心脏复律除颤器（WCD））的新应用，并通过改善从该设备获取的数据管理，提高慢性心力衰竭患者的护理质量。本病例报告描述了一名71岁男性的临床病程，该患者在急性心脏失代偿和近期诊断为缺血性心肌病导致左心室功能严重下降后，根据当前指南接受WCD治疗，直至最终决定是否植入植入式心脏转复除颤器（ICD）。通过远程医疗中心（TMC）以结构化方式对WCD收集的数据进行评估，发现了先前已知的阵发性心房颤动（AF）复发。这使得在再次发生心脏失代偿之前，通过调整药物治疗和早期启动肺静脉隔离（PVI）来治疗阵发性AF成为可能。该病例例证了结构化远程医疗干预的实用性，它能够有意义地补充既定的患者护理概念，改进现有概念并显著改善患者护理。
