Key result
Remote monitoring allowed the early and reliable detection of ICD lead failure in 7.5% of patients with leads under advisory over a mean follow-up of 22 months.
Why the study?
Does remote monitoring improve the early detection of lead failure in patients with ICD leads under advisory?
Observational (n=40)
Does remote monitoring improve the early detection of lead failure in patients with ICD leads under advisory?
Remote monitoring allows for the early and reliable detection of ICD lead failure in patients with leads under advisory, often before inappropriate therapies occur.
Supports remote monitoring for early advisory ICD lead failure detection; leaves open impact on outcomes and need for randomized confirmation.
AIMS: Automatic daily transmission of data from implantable cardioverter-defibrillators (ICDs) enables the remote monitoring of device status and leads function. We report on a 2-year experience with remote monitoring in 40 recipients of high-voltage ICD leads, prone to fracture and under advisory since October 2007. METHODS AND RESULTS: The ICDs were remotely monitored as well as systematically interrogated in the ambulatory department every 3 months. The patients were also seen in case of abnormal lead impedance, or other manifestations consistent with lead dysfunction. Over a mean follow-up of 22 ± 4 months after ICD implantation, four lead dysfunctions were suspected because of remotely transmitted oversensing of noise artifacts, abrupt rise in pacing impedance, or both. A lead fracture needing lead replacement was confirmed in three patients (7.5%), two of them before any inappropriate therapy and one after the delivery of three inappropriate shocks. No lead failure was observed in the remaining 36 patients, either at the time of ambulatory visits or during remote monitoring. CONCLUSION: Remote monitoring allowed the early and reliable detection of ICD leads failure without requiring any patient intervention.
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Guédon-Moreau et al. (2010) conducted an observational in High-voltage ICD leads prone to fracture and under advisory (n=40). Remote monitoring was evaluated on Lead fracture needing lead replacement. Remote monitoring allowed the early and reliable detection of ICD lead failure in 7.5% of patients with leads under advisory over a mean follow-up of 22 months.
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