Home monitoring of implantable cardioverter-defibrillators: interpretation reliability of the second-generation "IEGM Online" system
Language English Country England, Great Britain Media print-electronic
Document type Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't
PubMed
25567067
PubMed Central
PMC4381835
DOI
10.1093/europace/euu349
PII: euu349
Knihovny.cz E-resources
- Keywords
- Arrhythmia detection, Home monitoring, Implantable cardioverter-defibrillator, Intracardiac electrogram, Remote monitoring, Telemedicine,
- MeSH
- Defibrillators, Implantable * MeSH
- Electrocardiography methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Observer Variation MeSH
- Online Systems MeSH
- Reproducibility of Results MeSH
- Sensitivity and Specificity MeSH
- Arrhythmias, Cardiac diagnosis therapy MeSH
- Telemedicine methods MeSH
- User-Computer Interface MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Research Support, Non-U.S. Gov't MeSH
AIMS: Intracardiac electrograms (IEGMs) are essential for the assessment of implantable cardioverter-defibrillator (ICD) function. The Biotronik Home Monitoring systems transmit an 'IEGM Online' that is shorter than the full-length programmer IEGM due to technical constrains. The aim of this study was to evaluate the accuracy of the physician's classification of the underlying rhythm based on the second-generation IEGM Online. METHODS AND RESULTS: In total, 1533 patients treated with single- and dual-chamber ICDs and cardiac resynchronization therapy defibrillators were enrolled at 67 investigational sites and followed for 15 months. The investigators classified the rhythm shown in IEGM Online as ventricular tachycardia, ventricular fibrillation, atrial fibrillation, other supraventricular tachyarrhythmia, oversensing due to lead failure, T-wave oversensing, or other rhythm. At the next in-office follow-up, the investigators classified independently the rhythm seen in the corresponding programmer IEGM. The two rhythm classifications were compared thereafter. Both IEGM Online and programmer IEGM were available in 2099 arrhythmic or oversensing events, of which 146 (7.0%) were classified as other rhythm or artefacts and were excluded as inconclusive or atypical. The remaining 1953 events, affecting 352 patients (23.0%), were classified correctly in 1803 cases (92.3%). The accuracy of rough rhythm classification as ventricular, supraventricular, or oversensing was 97.2%. CONCLUSION: The Lumax and IEGM Online HD Evaluation study demonstrates that remote IEGM analysis is reasonably accurate in a remote monitoring system that transmits shorter IEGM than the full-length programmer IEGM for the sake of frequent, fully automatic data transmission.
Biotronik SE and Co KG Berlin Germany
Charité University Medicine Berlin Campus Charité Mitte Berlin Germany
Department of Cardiology Isala Klinieken Zwolle The Netherlands
Department of Cardiology Städtisches Klinikum München Bogenhausen Munich Germany
Department of Internal Medicine LKH Bruck an der Mur Bruck an der Mur Austria
Elisabeth Krankenhaus Recklinghausen Germany
Evangelisches Krankenhaus Düsseldorf Germany
Hannover Medical School Hannover Germany
Medical Clinic Hospital Reinbek St Adolf Stift Reinbek Germany
St Anne's University Hospital and International Clinical Research Center Brno Czech Republic
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