Remote monitoring of patients with implantable cardioverter-defibrillators: Can results from large clinical trials be transposed to clinical practice?

SummaryBackgroundRemote monitoring (RM) is increasingly used to follow up patients with implantable cardioverter-defibrillators (ICDs). Randomized control trials provide evidence for the benefit of this intervention, but data for RM in daily clinical practice with multiple-brands and unselected patients is lacking.AimsTo assess the effect of RM on patient management and clinical outcome for recipients of ICDs in daily practice.MethodsWe reviewed ICD recipients followed up at our institution in 2009 with RM or with traditional hospital only (HO) follow-up. We looked at the effect of RM on the number of scheduled ambulatory follow-ups and urgent unscheduled consultations, the time between onset of asymptomatic events to clinical intervention and the clinical effectiveness of all consultations. We also evaluated the proportion of RM notifications representing clinically relevant situations.ResultsWe included 355 patients retrospectively (RM: n=144, HO: n=211, 76.9% male, 60.3±15.2years old, 50.1% with ICDs for primary prevention and mean left ventricular ejection fraction 35.5±14.5%). Average follow-up was 13.5months. The RM group required less scheduled ambulatory follow-up consultations (1.8 vs. 2.1/patient/year; P<0.0001) and a far lower median time between the onset of asymptomatic events and clinical intervention (7 vs. 76days; P=0.016). Of the 784 scheduled ambulatory follow-up consultations carried out, only 152 (19.4%) resulted in therapeutic intervention or ICD reprogramming. We also found that the vast majority of RM notifications (61.9%) were of no clinical relevance.ConclusionRM allows early management of asymptomatic events and a reduction in scheduled ambulatory follow-up consultations in daily clinical practice, without compromising safety, endorsing RM as the new standard of care for ICD recipients

Importance de l'anatomie dans la déconnexion des veines pulmonaires (à propos de 51 patients traités par ablation par radiofréquence d'une fibrillation auriculaire)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Etude de l'efficacité de la stimulation antitachycardique en fonction du tracé de la tachycardie ventriculaire à l'implantation

LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Rôle du diabète dans la survenue des troubles du rythme ventriculaire chez les patients appareillés d'un défibrillateur automatique implantable

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Intérêt du rehaussement tardif au gadolinium en IRM dans la stratification du risque de mort subite dans la tétralogie de Fallot

LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

La dystrophie myotonique de type 1 et ses complications cardiaques (les enjeux d'un suivi cardiologique difficile)

LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

L'ablation de fibrillation auriculaire par radiofréquence : l'expérience lilloise (évaluation du scanner dans l'étude des veines pulmonaires)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Pulmonary vein isolation alone or in combination with substrate modulation after electrical cardioversion failure in patients with persistent atrial fibrillation: The PACIFIC trial: Study design

International audiencePulmonary vein isolation (PVI) is effective at treating 50% of unselected patients with persistent atrial fibrillation (AF). Alternatively, PVI combined with a new ablation strategy entitled the Marshall-PLAN ensures a 78% 1-year sinus rhythm (SR) maintenance rate in the same population. However, a substantial subset of patients could undergo the Marshall-PLAN unnecessarily. It is therefore essential to identify those patients who can be treated with PVI alone versus those who may truly benefit from the Marshall-PLAN before ablation is performed. In this context, we hypothesized that electrical cardioversion (EC) could help to select the most appropriate strategy for each patient

Major Adverse Events With Percutaneous Left Atrial Appendage Closure in Patients With Atrial Fibrillation

International audienc

Left Atrial Appendage Closure in Atrial Fibrillation

International audienc