Remote monitoring of cardiovascular implantable electronic devices in France. The French Electra survey

Abstract

Goal To evaluate routine Remote Monitoring (RM) of Cardiovascular Implantable Device (CID). A multiple choice questionnaire was e-mailed to 100 French physicians Implanters of CID in November 2017. A total of 73 answers were obtained (73%). Seventy five percent work in a public center, twenty three percent in a private center. The rate of Internal Cardiac Defibrillator implantation (ICD)/year per center is > 100 for 63%, 50–100 for 24,7%, < 50 for 6.8% and none for 5.5%. The number of patients followed with RM is > 1000 (9.6%), 500–1000 (27.4%), 200–500 (41.1%), < 200 (18%). 21.9% followed only ICD, 78.1% all type of CID; 80% declare proposing RM to almost all ICD implanted patients. A total of 75.3% of physicians are referent for RM, 23.3% receive information from referent RM team. Eighty five percent obtain systematic inform consent from patients before activation of RM. Onsite registration and transmitter delivery (or order card) is performed by paramedical staff (68%), engineer (25%), physician (4.1%) Follow-up is performed by paramedical staff collaborating with physicians (68.5%), physicians only (26%). A total of 71.3% communicate a phone number to patients but only 42.5% deliver opening office schedule. During programmed follow-up a specific report is systematically created by 42.5%; information is delivered only in case of significant alert by 30.1% and non-specific PDF report is sent by 8.2%. There are 76.7% archive data but only 43.8% are exhaustive. Remote monitoring of CID is a current practice in France especially for ICD follow up. Collaboration with paramedical staff is partial. Patients are informed but not systematically. Data are archived but partially. Absence of funding may explain incomplete and heterogeneous RM activity in France.