Feasibility and Problems on Remote Monitoring System under Management of a Rural Hospital

Abstract

Background: Our hospital is situated in rural Japan. Remote monitoring systems for cardiac-implanted devices, such as implantable pacer-generators (IPG) or implantable cardioverter-defibrillators (ICD), are usable in areas hardly accessible by means of public transportation. However, the systems are not readily operable by elderly patients.Objective: Clarification on the feasibility of using the system, and problems on the remote monitoring system.Method: Form April 2010 to May 2011, we introduced remote monitoring systems for 26 patients (mean age: 71.3±10.6; %male 84%). We retrospectively studied the patients, background, the frequency of transmission, and the data transmitted. And we compared the frequency of transmission by the elderly group (age >=75) with the younger group.Results: The implanted devices were ICD for 20 cases (16 cases, with Optivol system) and IPG for 6 cases (3 cases, with ATP system). Frequency of transmission: 95 (total), 3.8±3.2 (mean and SD), 89 (planned), 11 (unplanned), respectively. In the elderly group, the frequency of transmission: 2.1±1.7, which was smaller than in the younger group (4.9±3.5, p<0.05). Transmitted data (planned): No event 50, AT/AF 26, SVT/NST 6, VT/VF (no Tx) 6, Optivol 11, (unplanned): VT/VF (with Tx) 5, SVT 1, Optivol+AT 4.Conclusion: For elderly patients, the use of remote monitoring systems is feasible to promptly detect the device status but the difficulty of data transmission remains intact.