Abstract 15305: Feasibility and Performance of a Diagnosis-only Cardiac Implantable Electronic Device Interrogation System and Process for Use in a Hospital Environment

Abstract

Introduction: Interrogation of cardiac implantable electronic devices (CIEDs) typically requires in-person evaluation. When needed urgently in a hospital environment, the need for a company representative and/or specially trained physician/nurse delays diagnosis and increases resource utilization. A diagnosis-only remote interrogation device and process for Boston Scientific (BSC) CIEDs was developed to address this situation. Methods: LATITUDE Consult is a read-only interrogator that provides 24/7 access to expert technical review of data retrieved from a BSC CIED without requiring on-site access to a full-function programmer or specially trained personnel. Usage metrics, reason and results for each interrogation were recorded during the initial launch of the system. Results: 53 communicators were used in hospitals and clinics across 15 states. There were 509 discrete transmissions (ICD in 39%; PPM 35%; CRT-D 26%), most commonly from the ER (n=294, 58%) or PACU (n=145, 28%). A third of transmissions occurred outside of “working hours”. Results were communicated within 15 minutes in 89% of cases. The most common reasons for device check were evaluation of symptoms, post-procedure check, and shock evaluation. Transmissions were categorized as: no episodes in past 72 hours and no out of range measurements (n=174, 34%); episodes in past 72 hours but no out of range measurements (n=170, 33%); further review recommended (n=130, 26%). Overall, only 53 (10%) transmissions were classified as urgent and required immediate attention (Table). Conclusions: We demonstrate the feasibility of a stand-alone system that can rapidly interrogate a BSC CIED in a variety of hospital settings, even outside of traditional business hours. For 90% of all device interrogations, immediate attention was not required; this allows resources to be efficiently focused on the small minority of patients with an urgent device related issue.