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Cardiac Implantable Electronic Devices

Remote Monitoring

Home Monitoring (Biotronik) and

CareLink (Medtronic) systems

Basic Functioning and Organization

Renato P. Ricci

Cardiovascular Department

San Filippo Neri Hospital, Rome, Italy

Expected benefits from Remote Monitoring

Ø Early detection of device and lead malfunctions. Detection of battery depletion and abnormal device status (recall).

Ø Early awareness of diagnostic data stored in the device memory (atrial and ventricular arrhythmias, heart rate trends, daily activity, HRV, spontaneous beat percentages, ICD therapies)

Ø Continuous monitoring of device functions (threshold, sensing)

Ø Early reaction to change in clinical status and timely assessment of therapy changes

Ø Health Care Source saving by avoiding unnecessary visits.

The New Scenario

2008

The New Opportunity

Care Link: How does it work?

Manual Transmission

Automatic Transmission

Manual transmission

The patient holds the mouselike antenna of Medtronic CareLink monitor over the implanted cardiac

device

Data are sent from the Medtronic CareLink monitor to a secure server via a standard phone line

The clinicians review the patients’ device data on the Medtronic CareLink Clinician website

Automatic Transmission

Automatic Trasmission

CareAlerts

Clinic staff can	The device automatically
preschedule up to 6	“wakes up” at the scheduled
automatic device	time and communicates with
checks for each	the Medtronic CareLink
patient	Monitor. Data are
	transferred automatically as
	the patient sleeps.

Data are transferred	The clinician
to a secure server via	reviews the
the patient’s	patient’s device
standard phone line.	data on the
	secure website

Home Monitoring® Flow Chart (Biotronik)

Home Monitoring® System Tailoring of Alert Events

For each patient, trigger events are selected on individual clinical evaluation and updated during the follow-up.

The alerts are addressed to the nurse responsible for the patient.