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10th Anniversary of JCDD—Remote Monitoring with Cardiac Implanted Electronic...
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10th Anniversary of JCDD—Remote Monitoring with Cardiac Implanted Electronic Devices in Electrophysiology and Cardiovascular Physiology

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Electrophysiology and Cardiovascular Physiology".

Deadline for manuscript submissions: 28 February 2025 | Viewed by 5996

Special Issue Editors

Prof. Dr. Giuseppe Boriani

E-Mail Website
Guest Editor
Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, Modena University Hospital, University of Modena and Reggio Emilia, 41121 Modena, Italy
Interests: arrhythmias-general; atrial fibrillation; device therapy; chronic heart failure; public health and health economics
Special Issues, Collections and Topics in MDPI journals
Dr. Massimiliano Maines

E-Mail Website
Guest Editor
Cardiology Department, Ospedale di Rovereto, 38123 Rovereto, Italy
Interests: remote monitoring; cardiac pacing; device therapy; arrhythmias; heart failure

Special Issue Information

Dear Colleagues,

Remote patient monitoring is an element of telehealth. It involves the collection, transmission, and evaluation of relevant patient data using electronic devices, as well as decision making regarding appropriate clinical management. Cardiac implantable electronic devices (CIED) have extensive remote monitoring capabilities based on validated sensors that enable the collection of data on the device performance, arrhythmic profile, patient physical activity, and a series of parameters related to pathophysiological changes, including the detection of impending or worsening heart failure. To improve the management of patients with heart failure, several patient-specific parameters can be remotely monitored through CIEDs and combined to derive multiparametric scores for the prediction of a patient’s risk of worsening heart failure, with a good sensitivity and moderate specificity.

Pre-clinical alerts are remotely transmitted by CIEDs to physicians, thus enabling early patient management with the potential to prevent hospitalizations due to heart failure. However, this requires an appropriate form of organization, involving close coordination between physicians in charge of patient care, nurses, technicians, patients, and caregivers.

This Special Issue aims to provide an overview of the progress achieved in recent years regarding the technology of remote monitoring through CIEDs, as well as progress in the organization of remote care. It aims to define questions that are still open regarding the clinical management of alerts, coordination between caregivers, and coverage and reimbursement from the perspective of the implementation of remote patient monitoring as a standard of care for patients using CIEDs.

Prof. Dr. Giuseppe Boriani
Dr. Massimiliano Maines
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • remote monitoring
  • cardiac pacing
  • device therapy
  • arrhythmias
  • heart failure
  • integrated care
  • decision making
  • guidelines
  • digital health
  • telemedicine

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Published Papers (3 papers)

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11 pages, 1016 KiB  
Review
Remote Monitoring of Cardiac Implantable Electronic Devices in Very Elderly Patients: Advantages and Specific Problems
by Roberto Scacciavillani, Leonidas Koliastasis, Ioannis Doundoulakis, Sotirios Chiotis, Athanasios Kordalis, Maria Lucia Narducci, Sotiris Kotoulas, Gaetano Pinnacchio, Gianluigi Bencardino, Francesco Perna, Gianluca Comerci, Konstantinos A. Gatzoulis, Dimitris Tsiachris and Gemma Pelargonio
J. Cardiovasc. Dev. Dis. 2024, 11(7), 209; https://doi.org/10.3390/jcdd11070209 - 3 Jul 2024
Cited by 1 | Viewed by 3486
Abstract
Cardiac implantable electronic devices (CIEDs) offer the benefit of remote monitoring and decision making and find particular applications in special populations such as the elderly. Less transportation, reduced costs, prompt diagnosis, a sense of security, and continuous real-time monitoring are the main advantages. [...] Read more.
Cardiac implantable electronic devices (CIEDs) offer the benefit of remote monitoring and decision making and find particular applications in special populations such as the elderly. Less transportation, reduced costs, prompt diagnosis, a sense of security, and continuous real-time monitoring are the main advantages. On the other hand, less physician–patient interactions and the technology barrier in the elderly pose specific problems in remote monitoring. CIEDs nowadays are abundant and are mostly represented by rhythm control/monitoring devices, whereas hemodynamic remote monitoring devices are gaining popularity and are evolving and becoming refined. Future directions include the involvement of artificial intelligence, yet disparities of availability, lack of follow-up data, and insufficient patient education are still areas to be improved. This review aims to describe the role of CIED in the very elderly and highlight the merits and possible drawbacks. Full article
(This article belongs to the Special Issue 10th Anniversary of JCDD—Remote Monitoring with Cardiac Implanted Electronic Devices in Electrophysiology and Cardiovascular Physiology)
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6 pages, 192 KiB  
Brief Report
Remote Monitoring: How to Maximize Efficiency through Appropriate Organization in a Device Clinic
by Massimiliano Maines, Giancarlo Tomasi, Luisa Poian, Marzia Simoncelli, Debora Zeni, Monica Santini and Maurizio Del Greco
J. Cardiovasc. Dev. Dis. 2024, 11(9), 270; https://doi.org/10.3390/jcdd11090270 - 30 Aug 2024
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Abstract
Introduction: Remote device monitoring is indicated under class I A standard of care according to the latest HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Practical Management of the Remote Device Clinic. Despite this strong endorsement and the supporting data, the adoption of remote monitoring practices [...] Read more.
Introduction: Remote device monitoring is indicated under class I A standard of care according to the latest HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Practical Management of the Remote Device Clinic. Despite this strong endorsement and the supporting data, the adoption of remote monitoring practices remains lower than expected. One cause of the underutilization of telemonitoring devices is work overload. Thus, a crucial point for improving the adoption of remote monitoring systems is ensuring their sustainability. Materials and Method: After analyzing the resources necessary to manage a device telemonitoring clinic, we initiated a process to reduce redundant transmissions: 1. eliminated scheduled loop recorder transmissions, retaining only alert transmissions; 2. reduced the frequency of the scheduled transmissions of pacemakers from four to one per year and the scheduled transmissions for defibrillators from four to two per year; and 3. optimized and customized the programming of device alerts with two primary interventions. Results: These strategies allowed us to significantly reduce the number of transmissions/patient/year from 7.3 to 4.7. The first change was made in January 2020, which eliminated scheduled transmissions for loop recorders, reduced transmissions per patient from 14 to 10.4 for loop recorders, and decreased global transmissions per patient from 7.6 to 6.5. The subsequent adjustment in January 2021, which reduced the scheduled transmissions of pacemakers and defibrillators, further lowered transmissions per patient from 6.5 to 5.2 for pacemakers and from 4.7 to 3.1 for defibrillators. Additionally, enhanced attention to device reprogramming starting in January 2022 resulted in a further reduction in transmissions per patient from 5 to 4.7. Conclusion: Carrying out some simple changes in the number of scheduled transmissions and optimizing the programming of the devices made it possible to reduce the number of transmissions and make the remote monitoring of the devices more sustainable Full article
(This article belongs to the Special Issue 10th Anniversary of JCDD—Remote Monitoring with Cardiac Implanted Electronic Devices in Electrophysiology and Cardiovascular Physiology)
10 pages, 1129 KiB  
Brief Report
The Potential of the HeartLogicTM Algorithm in Patients with a Left Ventricular Assist Device, an Initial Report
by Michelle Feijen, Anastasia D. Egorova, Laurens F. Tops, Meindert Palmen, J. Wouter Jukema, Martin J. Schalij and Saskia L. M. A. Beeres
J. Cardiovasc. Dev. Dis. 2024, 11(2), 51; https://doi.org/10.3390/jcdd11020051 - 1 Feb 2024
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Abstract
Background: Survival and quality-of-life of left ventricular assist device (LVAD) recipients improved significantly because of growing experience and technological advances. However, LVAD-related complication rates, including recurrent episodes of congestion, remain high. Early detection of fluid retention to provide a time-window for medical intervention [...] Read more.
Background: Survival and quality-of-life of left ventricular assist device (LVAD) recipients improved significantly because of growing experience and technological advances. However, LVAD-related complication rates, including recurrent episodes of congestion, remain high. Early detection of fluid retention to provide a time-window for medical intervention is the pillar in preventing hospitalizations. The multisensory HeartLogicTM algorithm accurately detected impending congestion in ambulant heart failure patients. The aim of the current study is to investigate the feasibility of HeartLogicTM-driven care in LVAD patients. Methods: Consecutive LVAD destination therapy patients were followed-up according the structured HeartLogicTM-based heart failure carepath. An alert triggered a device check-up, and the heart failure team contacted the patient to evaluate for signs and symptoms of impending congestion. An alert was adjudicated as true positive or unexplained. An episode of congestion not preceded by an alert was deemed as a false negative. Results: Data from 7 patients were included: the median age was 67 years [IQR 61–71], 71% were male and 71% had a non-ischemic aetiology. Total follow-up entailed 12 patient-years. All patients experienced at least one alert. In total, 33 alerts were observed. Majority of alerts (70%, n = 23) were driven by congestion and one alerts (15%) were clinically meaningful but not primarily fluid-retention-related (e.g., altered hemodynamic triggered by a pump thrombosis). Of all the alerts, five (15%) were classified as an unexplained alert, and during follow-up, four false negative episodes were documented. Conclusions: HeartLogicTM-driven care with continuous monitoring to detect impending fluid retention in LVAD patients was feasible and deserves further prospective validation. Full article
(This article belongs to the Special Issue 10th Anniversary of JCDD—Remote Monitoring with Cardiac Implanted Electronic Devices in Electrophysiology and Cardiovascular Physiology)
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