gms | German Medical Science

Background: In patients (p) with implantable cardioverter defibrillator (ICD) regulary controls have to be performed by general cardiologists (GC) respectively the implanting electrophysiological center (IEC). By development of long range telemetry it has become possible to transfer data of the ICD directly from the patient’s implant to the cardiologist respectively the IEC. This so called “Home Monitoring” (HM) also enables GC and the IEC to review ICD data in parallel via the internet in the sense of a linked follow-up (LF). Thus, an online backup for the GC can be provided by IEC for routine control. Considering the increasing numbers of implantations, routine controls at GC seems to be necessary.

Methods: This study examines if the management of ICD routine controls can be improved by means of HM at GC with IEC backup. Therefore 150 p with ICD and Home Monitoring feature will be enrolled and followed up for 2 years with respect to the following parameters: 1. number of controls at GC / IEC; 2. duration of controls at GC / IEC; 3. number of consultations between GC and IEC; 4. number of reports via HM; 5. distance between home of p and GC / IEC.

Results: We report the first 10 p (2 female, 8 male) with implanted ICD with HM feature integrated in LF in Germany. Indication for ICD implantation was in 5 p a coronary artery disease with survived suden cardiac death respectively non sustained ventricular tachycardia and an ejection fraction <30 %, 1 p with dilative cardiomyopathy and non sustained ventricular tachycardia, 4 p prophylactic with an ejection fraction <35 %. Mean age was 57±8 years, ejection fraction 33±13. In all p data of ICD were correctly transferred via internet to the GC and the IEC. The interval of ICD controls at the GC was 3±1 month and no controls had to be performed at the IEC. Duration of ICD controls at the GC was 9±4 minutes. Duration of ICD control via internet was 3±2 minutes for the GC and 1±3 minutes for the IEC. 2 contacts between GC and IEC via Internet / telephone as a back up for special ICD problems were necessary.

Summary: We could show for the first time in Germany that by the means of LF ICD data can be provided via internet for GC and IEC with a reduction of ICD controls in the IEC. Furthermore a successful back up for the GC by the IEC could be implemented.