Impact of remote monitoring in the reduction of inappropriate shocks related to implantable cardioverter-defibrillators lead fractures: A real life observational study - 02/12/14
, S. Boulé, L. Finat, S. Mouton, C. Marquié, C. Kouakam, F. Brigadeau, D. Klug, D. Lacroix, S. Kacet, L. Guédon-Moreau
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Résumé |
Background |
Lead fractures in implantable cardioverter-defibrillator (ICD) patients may cause inappropriate shocks. An early diagnosis is essential to prevent adverse clinical events. ICD remote monitoring permits prompt detection of lead fracture. Limited data define the impact of remote monitoring on inappropriate shocks related to lead fracture.
Aims |
To compare the number of inappropriate shocks related to lead fracture in patients with and without remote monitoring follow-up.
Methods |
We checked the registry of our institution and collected, between July 2007 and June 2014, 115 cases of right ventricular lead fractures. All relevant data were documented from patients’ files, device interrogations printouts and electronic records, and remote transmissions databases when applicable. We assessed the inappropriate shocks that were related to lead fracture. The first study endpoint was the number of inappropriate shocks per shocked patient.
Results |
Among the 82 patients with conventional follow-up and the 33 patients with remote monitoring, a first inappropriate shock occurred in 32.9% (n=27) and 30.3% (n=10, P=0.83) of the patients respectively. Shocked patients in the remote monitoring group underwent significantly lesser inappropriate shocks with a median of 3.5 [1.8 to 8.3] shocks per patient than those in the conventional follow-up group with a median of 10.0 [5.0 to 22.0] shocks per patient (P=0.03).
Conclusion |
Remote monitoring helps to reduce the number of inappropriate shocks in symptomatic ICD lead fractures.
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Vol 3 - N° 4
P. 185 - décembre 2014 Retour au numéro
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