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Virtual clinics for follow-up of pacemakers and implantable cardioverter defibrillators in children

Published online by Cambridge University Press:  02 September 2019

Georgia Spentzou ,
Kaitlin Mayne ,
Helen Fulton  and
Karen McLeod Open the ORCID record for Karen McLeod [Opens in a new window]
Georgia Spentzou*
Affiliation:
Department of Paediatric Cardiology, Royal Hospital for Children, Queen Elizabeth University Hospitals, Glasgow, Lanarkshire G51 4TF, UK
Kaitlin Mayne
Affiliation:
Department of Paediatric Cardiology, Royal Hospital for Children, Queen Elizabeth University Hospitals, Glasgow, Lanarkshire G51 4TF, UK
Helen Fulton
Affiliation:
Department of Paediatric Cardiology, Royal Hospital for Children, Queen Elizabeth University Hospitals, Glasgow, Lanarkshire G51 4TF, UK
Karen McLeod
Affiliation:
Department of Paediatric Cardiology, Royal Hospital for Children, Queen Elizabeth University Hospitals, Glasgow, Lanarkshire G51 4TF, UK
*
Author for correspondence: G. Spentzou, Department of Paediatric Cardiology, Royal Hospital for Children, Queen Elizabeth University Hospitals, Road, Glasgow G51 4TF, UK. Tel: +44 141 451 6508; Fax: +44 141 201 2215; E-mail: georgiaspentzou@nhs.net
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Abstract

There is growing interest in the use of digital medicine to reduce the need for traditional outpatient follow-up. Remote interrogation of pacemakers and implantable cardioverter defibrillators is now possible with most devices. The aim of our study was to evaluate the safety and efficacy of virtual pacing clinics in following up children with pacemakers and implantable cardioverter defibrillators, including epicardial systems.

Methods:

The study was retrospective over 8 years (2010–2017), with review of patient records and analysis of downloads from the implantable cardiac devices to the virtual clinics.

Results:

A total of 75 patients were set up for virtual clinic follow-up during the study period, 94.5% with a pacemaker and 5.5% an implantable cardioverter defibrillator. The majority (76.8%) had an epicardial system. Data on lead impedance, battery longevity, programmed parameters, detected arrhythmias, percentage pacing and delivered defibrillator therapies were obtainable by download. Lead threshold measurements were obtainable via download in 83.7% of the devices, including epicardial systems. No concerning device issue was missed. In 15% of patients a major issue was detected remotely, including three patients with lead fractures. The virtual clinics resulted in fewer hospital attendances while enhancing monitoring and enabling more frequent device checks. The vast majority (91.4%) of families who responded to a questionnaire were satisfied with the virtual clinic follow-up.

Conclusions:

Virtual clinics allow safe and effective follow-up of children with pacemakers and implantable cardioverter defibrillators, including those with epicardial systems and are associated with high levels of parent satisfaction.

Keywords

virtual clinicsremote monitoringpacemakersdefibrillatorschildren
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 10 , October 2019 , pp. 1243 - 1247
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Copyright
© Cambridge University Press 2019 

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