Background: The impact of home monitoring system in the early detection of ventricular arrhythmia and inappropriate shock in daily work is not clear. The aim of this study was to investigate the impact of home monitoring system on the early detection of ventricular arrhythmia and inappropriate shock in daily clinical practice.
Methods: Cases of implantable cardioverter defibrillator (ICD) implantation with or without the home monitoring system from June 2010 to October 2011 at our center were reviewed. Follow-up was scheduled after implantation. Data relating to the home monitoring ICD were retrieved using a remote transmitter system. Data relating to the other devices were obtained during scheduled follow-up or unscheduled visits.
Results: Our study involved 69 patients (mean age (68.4 ± 17.6) years, 64.3% males, 26 in the home monitoring group vs. 43 in the non-home monitoring group). In all, 561 ventricular arrhythmia episodes were detected in 17 patients (39.5%) in the non-home monitoring group: 495 episodes were ventricular tachycardia and 66 episodes were ventricular fibrillation; among these, 476 episodes of ventricular tachycardia and 45 episodes of ventricular fibrillation were appropriately diagnosed (96.1% and 68.2%, respectively). In the home monitoring group, 389 ventricular arrhythmia episodes were transmitted by the home monitoring system in nine patients (34.6%): 348 ventricular tachycardia episodes and 41 ventricular fibrillation episodes. Device detection was appropriate in 348 ventricular tachycardia episodes (100.0%) and 36 ventricular fibrillation episodes (87.8%). The home monitoring group showed a higher appropriate detection rate of ventricular tachycardia (P < 0.01) and ventricular fibrillation (P = 0.02). The proportion of inappropriate shock was comparable in the two groups (6/11 in the non-home monitoring group vs. 1/7 in the home monitoring group; P = 0.08).
Conclusions: The home monitoring ICD was able to provide information relating to inappropriate detection and shock earlier than conventional devices. It proved to be a reliable tool and has a strong potential to provide greater reaction time in the case of inappropriate shock.