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Updated: Sep 27, 2025
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Bluetooth-Enabled Implantable Cardiac Monitors and Two-Way Smartphone Communication for Patients With Hypertrophic
Sina Safabakhsh1, Darson Du1, Janet Liew1
1Centre for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
Insights
Implantable cardiac monitors (ICMs) with 2-way communication detect more nonsustained ventricular tachycardia (NSVT) in hypertrophic cardiomyopathy (HCM) patients than Holter monitors. This improves sudden cardiac death (SCD) risk stratification and patient management.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Sudden cardiac death (SCD) risk stratification in hypertrophic cardiomyopathy (HCM) often relies on Holter monitoring.
- The adequacy of short-term Holter monitoring for capturing arrhythmic burden is uncertain.
- Longer-term continuous monitoring may provide a more accurate assessment of risk.
Purpose of the Study:
- To assess the long-term incidence of nonsustained ventricular tachycardia (NSVT) in HCM patients.
- To compare the effectiveness of implantable cardiac monitors (ICMs) with Holter monitoring for NSVT detection.
- To evaluate a novel Bluetooth-enabled 2-way communication platform for remote patient management.
Main Methods:
- Prospective, single-arm, observational study of 33 HCM patients.
- Implantation of Abbott Confirm Rx ICMs.
- Monitoring via a protocolized care pathway with a 2-way communication platform.
Main Results:
- 20 patients (60.6%) experienced NSVT on ICM, with most previously undetected by Holter.
- 71 NSVT episodes detected; median time to first detection was 76.5 days.
- Remote monitoring facilitated efficient management of transmissions, with most requiring only text message follow-up.
Conclusions:
- Novel ICMs with 2-way communication are feasible for remote management of HCM patients.
- Prolonged monitoring with ICMs identifies more nonsustained arrhythmias than standard Holter monitoring.
- ICM data significantly impacted SCD risk stratification and patient management in HCM.
Background:
Sudden cardiac death (SCD) risk stratification in hypertrophic cardiomyopathy (HCM) currently relies on arrhythmic burden quantification by 24 or 48-hour Holter monitoring. Whether this approach adequately captures arrhythmic burden, compared with longer-term continuous monitoring, is unclear. We sought to assess the long-term incidence of nonsustained ventricular tachycardia (NSVT) in HCM patients at low or moderate SCD risk, using implantable cardiac monitors (ICMs) paired with a novel Bluetooth-enabled 2-way communication platform.
Methods:
This prospective, single-arm, observational study enrolled 33 HCM patients. Patients were implanted with an Abbott (Chicago, IL) Confirm Rx ICM and monitored using a protocolized care pathway.
Results:
A total of 20 patients (60.6%) had ≥ 1 episode of NSVT recorded on the ICM, the majority of whom had previous Holter monitors that did not identify NSVT (60%, n = 12). A total of 71 episodes of NSVT were detected. Median time to first NSVT detection was 76.5 days (range: 0-553 days). A total of 19 patients underwent primary prevention implantable cardioverter defibrillator implantation during an average follow-up of 544 days (range: 42-925 days). A total of 172,112 automatic transmissions were received, and 65 (0.04%) required clinical follow-up. A total of 325 manual transmissions were received and managed. A total of 14 manual transmissions (4.3%) required follow-up, whereas 311 (95.7%) were managed solely with a text message.
Conclusions:
Surveillance and reporting systems utilizing 2-way communication enabled by novel ICMs are feasible and allow remote management of patients with HCM. Prolonged monitoring with ICMs identified more patients with nonsustained arrythmias than did standard Holter monitoring. In many cases, this information impacted both SCD risk stratification and patient management.
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