Original article Technical and practical aspects of remote monitoring of implantable cardioverter-defibrillator patients in Poland – preliminary results

Background: The aim of remote monitoring of implantable cardioverter-defibrillators (ICD) is to increase the patient’s safety by early detection of technical or medical malfunctions and decrease the number of follow-up visits. Aim: To evaluate the feasibility and reliability of internet-based home monitoring of ICD recipients in Poland. Methods: Twenty-seven patients with ICD with remote monitoring options were evaluated; 20 (74%) patients had a single chamber ICD, 6 (22%) patients had a dual chamber ICD and one had an ICD with a resynchronisation therapy option. Medical and technical events reported by the remote monitoring system as well as interruptions in monitoring longer than 14 days were analysed. Results: The patients were followed for 12.7 ± 10.5 months. Two of them died because of heart failure (6 and 13 months after ICD implantation, respectively). The remote monitoring system reported medical events in 13 (48%) patients. In total, we received 32 event reports (from 1 to 19 per patient, mean 2.6) which were generated due to the detection of ventricular tachycardia (VT) (17 events in 9 patients), ventricular fibrillation (VF) (9 episodes in 6 patients), ineffective defibrillation with the maximal energy (5 reports in 3 patients) and supraventricular tachycardia in the VT detection window (1). Two patients had more than 3 VT/VF episodes during 24 h. There were no reports on technical abnormalities of the ICD system. Interruptions in home monitoring longer than 14 days occurred in 5 (18.5%) patients and lasted 2 to 14 weeks (mean 2.8 ± 7.1). The longest break was caused by the patient’s stay abroad. The remaining interruptions were caused by: journeys (5 episodes), hospitalisations (4), and a temporary stay in a place without sufficient GSM coverage (3). During the follow-up period there were no interruptions in monitoring caused by transmitter or ICD failure. All data received by the home monitoring system were confirmed during the follow-up visits. Conclusion: Remote monitoring of ICD recipients in Poland does not present technical difficulties and enables early detection of serious events in ICD patients.