Telemed J E Health - A review on remote monitoring technology applied to implantable electronic cardiovascular devices.

Tópicos

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Resumo

Implantable electronic cardiovascular devices (IECD) include a broad spectrum of devices that have the ability to maintain rhythm, provide cardiac resynchronization therapy, and/or prevent sudden cardiac death. The incidence of bradyarrhythmias and other cardiac problems led to a broader use of IECD, which turned traditional follow-up into an extremely heavy burden for healthcare systems to support. Our aim was to assess the impact of remote monitoring on the follow-up of patients with IECD. We performed a review through PubMed using a specific query. The paper selection process included a three-step approach in which title, abstract, and cross-references were analyzed. Studies were then selected using previously defined inclusion criteria and analyzed according to the country of origin of the study, year, and journal of publication; type of study; and main issues covered. Twenty articles were included in this review. Eighty percent of the selected papers addressed clinical issues, from which 94% referred clinical events identification, clinical stability, time savings, or physician satisfaction as advantages, whereas 38% referred disadvantages that included both legal and technical issues. Forty-five percent of the papers referred patient issues, from which 89% presented advantages, focusing on patient acceptance/satisfaction, and patient time-savings. The main downsides were technical issues but patient privacy was also addressed. All the papers dealing with economic issues (20%) referred both advantages and disadvantages equally. Remote monitoring is presently a safe technology, widely accepted by patients and physicians, for its convenience, reassurance, and diagnostic potential. This review summarizes the principles of remote IECD monitoring presenting the current state-of-the-art. Patient safety and device interaction, applicability of current technology, and limitations of remote IECD monitoring are also addressed. The use of remote monitor should consider the selection of patients, the type of disease, and centers' availability to receive, interpret and respond to device alerts. Before remote IECD monitoring can be routinely used, technical, procedure, and ethical/legal issues should be addressed.

Resumo Limpo

implant electron cardiovascular devic iecd includ broad spectrum devic abil maintain rhythm provid cardiac resynchron therapi andor prevent sudden cardiac death incid bradyarrhythmia cardiac problem led broader use iecd turn tradit followup extrem heavi burden healthcar system support aim assess impact remot monitor followup patient iecd perform review pubm use specif queri paper select process includ threestep approach titl abstract crossrefer analyz studi select use previous defin inclus criteria analyz accord countri origin studi year journal public type studi main issu cover twenti articl includ review eighti percent select paper address clinic issu refer clinic event identif clinic stabil time save physician satisfact advantag wherea refer disadvantag includ legal technic issu fortyf percent paper refer patient issu present advantag focus patient acceptancesatisfact patient timesav main downsid technic issu patient privaci also address paper deal econom issu refer advantag disadvantag equal remot monitor present safe technolog wide accept patient physician conveni reassur diagnost potenti review summar principl remot iecd monitor present current stateoftheart patient safeti devic interact applic current technolog limit remot iecd monitor also address use remot monitor consid select patient type diseas center avail receiv interpret respond devic alert remot iecd monitor can routin use technic procedur ethicalleg issu address

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