Feature | EP Lab | May 15, 2015

Remote Monitoring Recommended by HRS to Become Standard of Care

International panel of experts advocates for continuous monitoring supplemented with annual in-person appointments

HRS, remote monitoring, RM, standard of care, CIEDs

May 15, 2015 — A new expert consensus statement by the Heart Rhythm Society (HRS) recommends remote monitoring (RM) become standard of care for patients with cardiovascular implantable electronic devices (CIEDs). The HRS Expert Consensus Statement on Remote Interrogation and Monitoring for Cardiovascular Electronic Implantable Devices was written by an international group of experts and published online in HeartRhythm Journal, the official journal of HRS. This new approach presents a new paradigm for managing patients with CIEDs and will be presented at Heart Rhythm 2015, the Heart Rhythm Society’s 36th Annual Scientific Sessions.

Over the past decade, novel technologies have created the ability for devices to monitor their own function, record arrhythmias and communicate this information to healthcare providers without participation of the patient. Enrollment in RM has become accessible to all patients and allows doctors to monitor a patient’s device between follow-up visits and alerts them to any issues via wireless technology.

The new expert consensus statement builds upon the 2008 HRS/EHRA Expert Consensus on the Monitoring of Cardiovascular Implantable Electronic Devices (CIEDs), and reinforces the need for consistent follow-up and outlines the limitations of in-person-only follow-up. The writing group focuses on the organizational change required to most effectively implement RM by replacing the occasional, routine appointment to a system of nearly continuous monitoring, making it more convenient and efficient for the patient and healthcare provider. Recommendations also include that the patient have an in-person evaluation at the physician’s office in response to alert notifications communicated by RM.

“We’ve seen firsthand how the constant and continuous communication between the patient’s device and the healthcare provider is improving the quality and efficiency of care. There are proven advantages for the patient and we outline a specific strategy on how remote monitoring can benefit both patients and providers,” said task force chair and lead author of the statement, David Slotwiner, M.D.,FHRS,  Hofstra School of Medicine, North Shore-Long Island Jewish Health in New Hyde Park, New York. “We hope that this type of wireless, remote monitoring that provides real-time insights to the patient’s healthcare team can become a model for managing other chronic conditions.”

Key recommendations within the expert consensus statement include the following:

  • Remote monitoring should be combined with at least an annual in-person evaluation and all patients with CIEDs should be offered remote monitoring as part of the standard follow-up management strategy;
  • Before implementing RM, it is recommended that each patient be educated about the nature of RM, responsibilities and expectations, potential benefits, limitations and an explanation of how RM information may be used;
  • All CIEDs be checked through direct patient contact 2-12 weeks after being implanted; and
  • Have specific policies in place to govern program operations, roles and responsibilities of those involved and the expected timelines for service provision.

 

The expert consensus statement was developed in collaboration with the American College of Cardiology (ACC), Pediatric & Congenital Electrophysiology Society (PACES), the American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), the European Heart Rhythm Association (EHRA) and Latin American Society of Cardiac Pacing and Electrophysiology (Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología, SOLAECE).   

For more information: www.hrsonline.org

Related Content

A new infection risk scoring system has been developed based on data from the large PADIT Trial.[1] The new scoring system was presented as a follow up to that study during a late-breaking session at Heart Rhythm 2019, the Heart Rhythm Society's 40th Annual Scientific Sessions.

Figure 1: The PADIT infection risk score ranging from 0 to 14 points classified patients into three risk groups, low (0-4), intermediate (5-6) and high (≥7). The risk groups had rates of hospitalization for infection of 0.51%, 1.42% and 3.41%, respectively 

News | EP Lab | May 15, 2019
May 15, 2019 — A new infection risk scoring system has been developed based on data from the large PADIT Trial.[1] Th
Studies Find Race and Gender Disparities in Implantable Heart Devices
News | EP Lab | May 15, 2019
May 15, 2019 - Three new studies show that patients who are medically indicated for implantable heart devices, includ
Heart Rhythm 2019 study shows travelers with common cardiac devices can pass through without restrictions or precautions. HRS 2019, #HRS #HRS19

A new study shows travelers with common cardiac devices can pass through airport body scanners without restrictions or precautions.

News | EP Lab | May 14, 2019
May 14, 2019 – Results from new research show that passengers with cardiac implantable electronic devices (CIEDs), su
News | EP Lab | May 13, 2019
May 13, 2019 – Results from a new survey are the first to report a large discrepancy in patient’s knowledge of their
Concerto CRT-D and Virtuoso ICD implantable cardiac devices are among several Medtronic electrophysiology devices included in a safety alert because of their lack of cybersecurity measures to avoid hacking, according to the FDA.

Concerto CRT-D and Virtuoso ICD implantable cardiac devices are among several Medtronic electrophysiology devices included in a safety alert because of their lack of cybersecurity measures to avoid hacking, according to the FDA.

Feature | EP Lab | March 22, 2019
March 22, 2019 — The U.S.
Medtronic Tyrx Envelope Significantly Reduces Major Infections in Cardiac Implantable Device Patients
News | EP Lab | March 20, 2019
Results from the landmark Worldwide Randomized Antibiotic Envelope Infection Prevention Trial (WRAP-IT) demonstrated...
Videos | EP Lab | February 27, 2019
This is a virtual heart with the same electrophysiology characteristics as the real patient being developed to help o
Seth Worley, M.D., senior consultant, section of cardiac electrophysiology, MedStar Heart and Vascular Institute, developed tools and techniques to optimize transvenous left ventricular (LV) lead implantation, including the I-CRT approach. Here he holds the tools that he personally developed for left ventricular lead implantation to treat heart failure. Photo courtesy of MedStar Heart and Vascular Institute at MedStar Washington Hospital Center.

Seth Worley, M.D., senior consultant, section of cardiac electrophysiology, MedStar Heart and Vascular Institute, developed tools and techniques to optimize transvenous left ventricular (LV) lead implantation, including the I-CRT approach. Here he holds the tools that he personally developed for left ventricular lead implantation to treat heart failure. Photo courtesy of MedStar Heart and Vascular Institute at MedStar Washington Hospital Center.

Feature | EP Lab | January 21, 2019 | Matthew S. McKillop, M.D., FACC, FHRS, and Seth J. Worley, M.D.
Interventional...
An implanted ICD showing its three venous leads. These multiple CRT leads can cause issues when they need to be replaced and are abandoned with new leads put over them in the SVC, which may require lead extraction.

An implanted ICD showing its three leads in the venous system. 

Feature | EP Lab | January 13, 2019 | Dave Fornell, Editor
To extract or abandon broken or infected implantable, venous...
Overlay Init