P577Early experience with the first pacemakers to directly connect with smart devices for remote monitoring

Background

Remote monitoring is associated with improved patient outcomes; however, adoption and adherence to remote monitoring via home-based consoles remains suboptimal. BlueSync technology in new generation pacemaker and CRT-P models enables the implanted device to communicate directly with patient-owned, Bluetooth-equipped smartphones/tablets and an app (MyCareLink Heart). The app can automatically retrieve information from the cardiac device and transmit the data to the remote network, eliminating the need for traditional remote monitoring consoles.

Objectives

To characterize the communication process between implanted pacemakers and smart device remote monitoring apps by assessing the success of prescheduled remote transmissions in the first month of follow-up. Additionally, to assess the feedback of both patients and clinicians about the process of device pairing.

Methods

Enrollment in the BlueSync Field Evaluation began in April 2018 and was completed November 2018. Follow-up is ongoing. Prior to enrollment in the evaluation, patients completed the device pairing process with the app using their own compatible smartphone or tablet. Patient and clinician questionnaires were completed at the time of the device pairing process. After enrollment, successful completion of scheduled transmissions occurring in the first month were analyzed.

Results

Preliminary data includes 241 enrolled patients with mean age of 64.7±15.5 yrs (min 20, max 90 yrs), who completed device pairing between their implanted device and their smart device app. Of enrolled patients, 79% felt that the device paring was easy to do, 85% were satisfied with the amount of time it took to complete it, and 93% felt that they would be comfortable using the app. Clinicians reported that 67% of the device pairings took less than 20 minutes and 78% felt patients would be able to use the app independently. At the time of analysis 174 patients had at least one scheduled transmission within the first month, and collectively had a total of 322 scheduled transmissions. Out of these, 309 (96%, 95% CI: 93%-98%) were successfully completed.

MyCareLink Heart App

Conclusions

Initial experience with the world's first app based remote monitoring system for Bluetooth enabled pacemakers demonstrated success to scheduled transmissions in the first month across a wide range of patient ages. Patients and clinicians reported high satisfaction with this novel technology.

Acknowledgement/Funding

Medtronic PLC

Fluoride ingestion and thyroid function in children resident of naturally fluoridated areas - An observational study

Background

Literature shows association between systemic fluorides with water fluoride level above 3ppm and endocrine disorders especially related to thyroid. Aim & Objectives: To estimate serum T3, T4, TSH, Fluoride levels among children with normal nutritional status and optimal iodine intake, residing in three different ranges of drinking water fluoride levels below 3ppm.

Material and Methods

Present double blinded observational trial comprised of 293 children aged between 9-13 years consuming naturally fluoridated water of 3 different ranges: Group I: 0.01 - 0.6ppm, Group II: 0.7-1.2ppm and Group III: 1.3-1.8ppm. For each child demographic data, BMI and Clinical Fluorosis Index were recorded along with serum T3, T4, TSH, Fluoride levels. Data was analyzed using Chi Square, Kruskal Wallis test and Repeated measures of ANOVA with SPSS 23.

Results

For serum TSH levels 40% of children of group I had deranged levels followed by group III (20%) and Group II (16%). For serum T4 levels 24% of children of both groups I and III had deranged levels followed by group II (20%). Inter group correlation of drinking water fluoride levels to number of deranged serum T3, T4, and TSH of the children showed non-significant association.

Conclusions

According to the present study results long term intake of fluoridated drinking water (0.02 -1.4 ppm) did not showed effect on the thyroid function in the children with normal nutritional status and optimal iodine intake.

Key words:Iodine, nutrition, serum fluoride, systemic fluoride, thyroid function test.