New capabilities provide an equally safe and more convenient option for monitoring
Cardiac arrhythmia patients at Brigham and Women’s Hospital (BWH) have always benefited from the latest innovations in device therapy, and now they have access to an innovative remote monitoring system for their ICDs (implantable cardioverter defibrillators), as well. Remote monitoring offers patients the convenient and timesaving option to have a device check from home instead of scheduling an office visit. Since its introduction at BWH in January 2006, over 400 patients have enrolled in the remote monitoring program, and approximately 100 additional patients enroll each month.
The remote monitor consists of a small battery-powered box with a detachable wand. At scheduled intervals, the patient connects the monitor to the home telephone line and places the wand on the skin overlying the defibrillator. The wand interrogates the defibrillator system and the monitor downloads and transmits the data to a secure web server. The entire process takes between five and 10 minutes. The monitor signals the patient when the download is finished, and the system powers down when transmission is complete.
Within minutes, physicians can log onto the secure web server and download a full device report. BWH electrophysiologists are using home monitoring for routine device checks, as well as for arrhythmic event monitoring. Patients appreciate the convenience of the remote monitoring system. It not only replaces one or two annual office visits for routine device check-ups, but also allows patients to be in immediate contact with physicians in case of an arrhythmic event. Referring physicians will continue to receive device reports from the attending electrophysiologist.
Julie B. Shea, NP, a nurse practitioner with the BWH Cardiac Arrhythmia Service says, “We tell patients that remote monitoring should not take the place of emergency care. However, if a patient believes he has had an event but is stable, he can download and transmit information from his ICD directly to his physician, who can determine whether the device has fired appropriately. We can often manage changes in patient therapy without bringing the patient in for an office visit.” The BWH arrhythmia team is enthusiastic about the convenience of remote monitoring and its potential to enhance patient care.
Laurence M. Epstein, MD, Chief of the Cardiac Arrhythmia Service and Director of the Electrophysiology and Pacing Laboratory at BWH, says, “We are beginning to use second-generation devices with advanced monitors that provide constant surveillance of system integrity as well as scheduled checks of heart rate and rhythm and any events that may have occurred. These newer monitors will also allow us to gather additional metrics, including weight and blood pressure, critical to managing heart failure patients. We also anticipate being able to program some ICD features remotely and to reset system integrity alerts without an office visit. As indications for ICD use expand, remote monitoring will continue to provide safety and convenience for patients and referring physicians.”
Send Feedback to: 
