Remote monitoring of implantable defibrillators is associated with fewer inappropriate shocks and reduced time to medical assessment in a remote and rural area

BACKGROUND Implantable cardioverter defibrillators(ICDs)and cardiac resynchronisation therapy with defibrillators(CRT-D)reduce mortality in certain cardiac patient populations.However,inappropriate shocks pose a problem,having both adverse physical and psychological effects on the patient.The advances in device technology now allow remote monitoring(RM)of devices to replace clinic follow up appointments.This allows real time data to be analysed and actioned and this may improve patient care.AIM To determine if RM in patients with an ICD is associated with fewer inappropriate shocks and reduced time to medical assessment.METHODS This was a single centre,retrospective observational study,involving 156 patients implanted with an ICD or CRT-D,followed up for 2 years post implant.Both appropriate and inappropriate shocks were recorded along with cause for inappropriate shocks and time to medical assessment.RESULTS RM was associated with fewer inappropriate shocks(13.6%clinic vs 3.9%RM;P=0.030)and a reduced time to medical assessment(15.1±6.8 vs 1.0±0.0 d;P<0.001).CONCLUSION RM in patients with an ICD is associated with improved patient outcomes.

T-wave oversensing and inappropriate shocks in implantable cardioverter defibrillators

The implantable cardioverter defibrillator （ICD） represents today the treatment and prophylaxis of choice for patients at risk for sustained ventricular tachyarrhythmias.1-6 Accurate sensing of ventricular tachyarrhythmias is a critical aspect of the function of ICD. All currently available models include algorithms with variable sensitivity, allowing adjustments which optimize the detection of low amplitude signals during ventricular tachyarrhythmia. However,