Cor Vasa 2011, 53(11):611-618 | DOI: 10.33678/cor.2011.155

Biotronik Home Monitoring system in clinical practice

Jolana Lipoldová^*, Miroslav Novák, Ivo Dvořák, Tomáš Vykypěl

1. interní kardioangiologická klinika, ICRC, FN u sv. Anny, Lékařská fakulta Masarykovy Univerzity, Brno, Česká republika

Introduction: Biotronik Home Monitoring (HM) is the most widely used system for remote monitoring of pacemaker (PM) and defibrillator (ICD) users in the Czech Republic. Implanted PM or ICD equipped with antenna emits a signal that is detected by the patient subunit CardioMessenger (CM). In the second-generation HM, the signal is being digitally transformed and re-sent in the GPRS form to the center in Berlin. The transferred information is analyzed automatically and the findings are made available to a physician using a secured server. This occurs every day at a predefined hour and any time when severe pathology or arrhythmia is detected.

Methods: Data from all implants followed using HM were evaluated retrospectively. ICD carriers were divided into subgroups according to the ICD indications: (1) secondary preventive indication (SPI) according to the 4.14.1, 4.14.2 a 4.14.3 paragraphs of the ČKS Guidelines, (2) primary preventive indication according to the 4.14.4 paragraph (PPI-M1), (3) primary preventive indication according to the 4.14.5 paragraph (PPI-M2), and (4) primary preventive indication according to the 4.14.6 paragraph (PPI-CMP).

Results: 218 implants including 212 ICD, followed for a mean period of 22.3 months, were analyzed. Reports about significant events - most often about arrhythmias (101 implants) - were sent by 62% implants. At least one ventricular arrhythmia was detected by 32% implants (the least often in PPI-M1 - 18%, the most often in SPI - 39%), at least one supraventricular arrhythmia was detected by 28% implants (the least often in PPI-M1 and SPI - 23%, the most often in PPI-CMP - 46 %). One half of the ventricular (supraventricular) arrhythmic events was reported within 6.4 (1.8) months from HM activation. Excessive sensitivity leading to false arrhythmia detection was described in 5% of devices. Inadequate therapy was applied in 1.8% devices. The percentage of performed biventricular stimulations decreased in 17% of biventricular devices. Significant technical problems were detected in 2.3% cases. The interruption of signal emission lasting longer than 21 days was found in 34% implants while permanent deactivation was revealed in 31% implants.

Conclusion: Biotronik Home Monitoring seems to be a reliable system enabling early detection of abnormal implant behavior and offering high degree of safety to the patients.

Keywords: Remote monitoring; Home Monitoring; Frequency of arrhythmias

Published: November 1, 2011  Show citation