Department of Cardiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands.
Department of Methodology and Statistics, Utrecht University, Heidelberglaan 8, 3584 CS, Utrecht, the Netherlands.
Expert Rev Med Devices. 2022 Sep;19(9):677-685. doi: 10.1080/17434440.2022.2132147. Epub 2022 Oct 25.
Despite an increasing population of patients supported with a left ventricular assist device (LVAD), it remains a complex therapy, and patients are frequently admitted. Therefore, a strict follow-up including frequent hospital visits, patient self-management and telemonitoring is needed.
The current review describes the principles of LVADs, the possibilities of (tele)monitoring using noninvasive and invasive devices. Furthermore, possibilities, challenges, and future perspectives in this emerging field are discussed.
Several studies described initial experiences on telemonitoring in LVAD patients, using mobile phone applications to collect clinical data and pump data. This may replace frequent hospital visits in near future. In addition, algorithms were developed aiming to early detect pump thrombosis or driveline infections. Since not all complications are reflected by pump parameters, data from different sources should be combined to detect a broader spectrum of complications in an early stage. We need to focus on the development of sophisticated but understandable algorithms and infrastructure combining different data sources, while addressing essential aspects such as data safety, privacy, and cost-effectiveness.
尽管越来越多的患者接受了左心室辅助装置（LVAD）的支持，但它仍然是一种复杂的治疗方法，患者经常需要住院治疗。因此，需要进行严格的随访，包括频繁的医院就诊、患者自我管理和远程监测。
本综述描述了 LVAD 的原理，以及使用非侵入性和侵入性设备进行（远程）监测的可能性。此外，还讨论了这个新兴领域的可能性、挑战和未来展望。
多项研究描述了使用移动电话应用程序收集临床数据和泵数据对 LVAD 患者进行远程监测的初步经验。这可能在不久的将来取代频繁的医院就诊。此外，还开发了旨在早期检测泵血栓或驱动线感染的算法。由于并非所有并发症都反映在泵参数中，因此应结合来自不同来源的数据，以早期检测更广泛的并发症谱。我们需要专注于开发复杂但易于理解的算法和基础设施，结合不同的数据来源，同时解决数据安全性、隐私和成本效益等基本方面。
