Early event detection using a home monitoring system for patients with cardiac pacemakers

To analyze the clinical applications and observe the priority of Home Monitoring (HM) systems for early event detection including clinical cardiac warning events, abnormal device parameters and other events in patients with permanent cardiac pacemakers.

A total of 58 patients who received dual-chamber pacemakers, ICDs and CRT-P/Ds were enrolled and monitored using the HM system for 416 ± 398 days. Automatic system-transmitted events by HM and related clinical information were recorded and consulted by well-trained physicians. Conventional and unconventional follow-up initialed by HM results were analyzed.

Forty patients (69 %) transmitted abnormal events via the HM system. Twenty-one of these were cardiac events. Atrial fibrillation (AF) was the most common transmitted clinical event. AF was detected an average of 44.26 ± 18.33 days earlier in HM patients than on routine clinical visits alone. A total of 20 patients reported 62 events related to abnormal device parameters. Among these events, disabled ACC/ATM function was the most common warning event (17 times) transmitted by 14 of the patients, and they were detected an average of 67.6 ± 29.0 days ahead of the routine office device follow-up. A total of seven patients reported silent events and totally eight patients were required to make an unscheduled clinical visit. Eighteen patients (31 %) transmitted no warning event and accepted no parameter adjustment during observation.

The HM system is useful in early detection of abnormal warning events as well as the primary detection of silent events in post-pacemaker implantation patients. Additionally, the HM system benefits patients during the whole process of device follow-up by real-time monitoring, and reduces medical costs effectively for patients with no abnormal reports or necessity of parameter adjustment.