Zartner PA, Mini N, Momcilovic D, Schneider MB, Dittrich S. Telemonitoring with Electronic Devices in Patients with a Single Ventricle Anatomy.
Thorac Cardiovasc Surg 2021;
69:e53-e60. [PMID:
34891178 PMCID:
PMC8672881 DOI:
10.1055/s-0041-1735479]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background A growing number of patients with a single ventricle anatomy, who had a
Fontan palliation as a child, are now reaching adulthood. Many need an epimyocardial
pacemaker system with an optional telemonitoring (TM) unit, which evaluates the collected
data and sends it via Internet to the patient's physician. There are no data on the
reliability and clinical relevance of these systems in this patient group.
Methods We analyzed data in 48 consecutive patients (mean age 18 years, standard
deviation 9 years) with a Fontan or Fontan-like palliation who received a cardiac
implantable electronic device with a TM unit from Biotronik (Home Monitoring) or Medtronic
(CareLink) between 2005 and 2020 with regard to the reliability and clinical relevance of
the downloaded data.
Results The observation period was from 4 months to 14 years (mean 7 years,
standard deviation 3.9 years). A total of 2.9 event messages (EMs)/patient/month and 1.3
intracardiac electrogram recordings/patient/month were received. Two patients died during
follow-up. The combination of regularly arriving statistical data and 313 clinically
relevant EMs led to the modification of antiarrhythmic or diuretic medication,
hospitalization with cardioversion or ablation, and cortisone therapy to avoid exit block
in 21 (44%) patients.
Conclusion TM is an instrument to receive functional and physiologic parameters of
our Fontan patients. It provides the ability to respond early for signs of system failure,
or arrhythmia, even if the patient is not experiencing any problems. It is a useful tool
to manage this difficult patient population without frequent hospital visits.
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