Efficacy of Remote Monitoring Systems for Reducing Inappropriate Shocks in Patients with ICD

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概要

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• <B>Introduction:</B> Inappropriate shocks (IAS) were associated with increased risk of mortality and deterioration of QOL in pts with ICD. To investigate the efficacy of remote monitoring systems (RM) for reducing IAS.<BR><B>Methods:</B> We retrospectively reviewed consecutive 202 pts who had been implanted ICDs from 2005. Incidence of IAS and device-related problems were reviewed in 101 pts under RM (CareLink (n=95)/HomeMonitoring (n=6)) during ≤2 yrs and in 101 control-pts (C) who underwent conventional scheduled-checks during ≤2 yrs after ICD implantation.<BR><B>Results:</B> Age, gender, AF, single-chamber ICD, Fidelis-lead, VF detection rate, treatment with amiodarone and β blockers were not significantly different between RM and C groups, except for idiopathic VF (26 vs. 18%; p<.05) and LVEF (48 vs. 42%; p<.05). Kaplan-Meier survival curve revealed significant reduction of IAS under RM compared to C group (p=0.032). A total of 10/15 device-related problems were detected in C/RM groups. Device problems were more often confirmed just after IAS in C than RM group (80 vs. 27%; p<.01). In RM group, 73% of problems had been managed 2±2 days after data detection and did not cause IAS. Multiple regression analysis showed that RM (OR; 0.29, 95%CI; 0.11–0.78, p<.05) and age (OR; 0.97, 95%CI; 0.94–0.996, p<.05) were independently associated with IAS.<BR><B>Conclusions:</B> Incidence of IAS may be reduced under RM which enables us to detect device-related problems before the delivery of IAS from ICD.

著者

• AIZAWA Yoshiyasu

  Keio University School of Medicine

• Fukumoto Kotaro

  Keio University school of Medicine Cardiology Division

• Takatsuki Seiji

  Keio University School of Medicine

• Fukuda Keiichi

  Keio University

• Maeda Akiko

  Cardiology Division Keio University School Of Medicine

• Sato Toshiaki

  Cardio-pulmonary Division Department Of Medicine Keio University School Of Medicine

• Ogawa Satoshi

  Keio University

• Maeda Akiko

  Cardiology, Second Department of Internal Medicine, Kyorin University Tokyo

• Aizawa Yoshiyasu

  Keio University, School of Medicine

• Kimura Takehiro

  Keio University, School of Medicine

• Nishiyama Nobuhiro

  Keio University, School of Medicine

• Soejima Kyoko

  Kawasaki Municipal Tama Hospital

• Takatsuki Seiji

  Keio University, School of Medicine

• Sato Toshiaki

  Cardiology, Second Department of Internal Medicine, Kyorin University Tokyo

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