Search NEL Online

Journal Article 2014; 35(Suppl 1): 54-58 PubMed PMID: 25433355 Citation  Keywords:  Anxiety:psychology, Arrhythmias, Cardiac:psychology, Defibrillators, Implantable:psychology, Depression:psychology, Humans, Psychology, Quality of Life:psychology,.   

: Various mental and social problems can negatively impact the quality of life and overall health in patients with implantable cardiac defibrillators (ICD). In this report, we review and summarize the main studies and research related to this topic. Depression, anxiety, panic attacks, stress and post-traumatic stress are the most common symptoms of ICD-related disorders that can negatively impact mental status. Factors than can influence the impact of these psychological disorders include socio-demographic variables (younger age, gender, and employment), variables related to the ICD (number of ICD shocks, generator size, time from ICD implant, etc.) and psycho-social variables (negative coping strategies, lack of social support and personality type). Fortunately, these disorders, and their symptoms, can be prevented, treated or managed, if recognized....

Read abstract  Full text PDF

Journal Article 2014; 35(Suppl 1): 40-48 PubMed PMID: 25433353 Citation  Keywords:  Aged, Aged, 80 and over, Death, Sudden, Cardiac:prevention & control, Defibrillators, Implantable, Female, Follow-Up Studies, Humans, Long-Term Care, Male, Middle Aged, Monitoring, Physiologic:methods, Outpatients, Pacemaker, Artificial, Prospective Studi.   

OBJECTIVE: The increasing number of patients with implantable cardiac devices raises the need for more efficient outpatient follow-up care. Due to technological progress in communication and transmission systems and in the implantable devices themselves, telemonitoring can be widely used as an important part of care for patients and devices. Our objective was to evaluate the benefits of continuous remote monitoring using the BIOTRONIK Home Monitoring® (HM) system compared to standard outpatient follow-ups.

METHODS: 198 patients with single- or dual-chamber implantable cardioverter-defibrillator (ICD) implanted for primary or secondary prevention of sudden cardiac death were randomized into a group of patients followed through standard outpatient visits ( HM-) and a group telemonitored by the HM system (HM+). Planned and emergency visits, ICD-related hospitalizations, and delivered shocks and their appropriateness were evaluated in the respective groups.

RESULTS: A significant reduction was achieved in the number of planned (by 48%, p<0.001) and total visits (by 45%, p<0.001) during a three-year evaluation. A comparable number of patients experienced one or more shocks. Mortality rates were equivalent, as was the number of patients hospitalized in relation to their ICD. However, there was a significant reduction in the number and proportion of inappropriate shocks delivered in the HM+ patient group: by 80% (p=0.002) in outpatient follow-up care and by 90% (p<0.001) when multiple shocks requiring hospitalization were included.

CONCLUSIONS: The HM system was an effective and safe method of follow-up in patients with an implanted ICD. Remote monitoring reduces the number of outpatient visits and inappropriate shocks....

Read abstract  Full text PDF