Remote Monitoring in Cardiac Resynchronization Therapy-First Experience in Romania with a CRT Virtual Ward

Curr Health Sci J. 2023 Apr-Jun;49(2):230-236. doi: 10.12865/CHSJ.49.02.230. Epub 2023 Jun 30.

Abstract

Background: Remote monitoring (RM) is becoming a standard of care for patients with cardiac resynchronization therapy (CRT). This technology combines the use of pacemakers or implantable cardioverter-defibrillators (ICD) and wireless communication to provide physicians with continuous, real-time information on the patient's cardiac activity. The purpose of the study was to evaluate if the remote monitoring technology in the follow-up CRT patients is feasible and safe.

Methods: A total of nine patients were enrolled in the study, implanted with a CRT system with wireless transmission capabilities. Immediately after the procedure received the RM, were enrolled in the virtual clinic and instructed by the doctor how to use the device at home. Regular virtual transmissions were made automatically every 3 weeks, respecting optimal transmission conditions. The accumulation of fluid in the lungs, atrial or ventricular tachyarrhythmia together with system integrity automatically activate alerts.

Results: One hundred and one transmissions were collected and analyzed from the virtual ward. Average follow-up was 7.7±4.8 months, longest follow-up was 18 months. None of the patients experienced complications during the study period, with three of them being follow-up solely through telemetric means by implanting physician. Treatment optimization was successfully conducted via phone consultations, when necessary, without any adverse events.

Conclusions: The results of our study suggest that RM could be integrated into routine CRT management protocols, enhancing patients care and resource utilization.

Keywords: CRT; ICD therapy; Remote monitoring; heart failure.