
BCS Conference 2017
AbstractTitle: REMOTE PACEMAKER FOLLOW UP FROM A CONVENIENT COMMUNITY LOCATION - A PILOT STUDY
Submission Date : 01/12/2015 22:22:57
Category: Cardiac Rhythm Management
KeyWords
Pacemaker, Remote, Carelink
Abstract Body
Introduction: All
patients with a cardiac pacemaker require regular routine follow up. At an
interval of no greater than twelve months battery longevity and lead parameters
require assessment. This is usually undertaken in secondary care, by a trained
cardiac physiologist, in a clinic setting. At University Hospital Southampton 2878 patients undergo
routine pacemaker follow up. Pacemaker prevalence increases with patient age.
Many patients with pacemakers are frail with multiple co-morbidities and a high percentage are
reliant on hospital transport. Hospital attendance for this cohort can be challenging
and costly. The pacemaker clinic has a high DNA (did not attend)
rate. In 2012, 285 appointment slots were not utilised (around 15% of
total appointments).
Two-thirds of our pacemaker patients have a remote
compatible Medtronic device. A single Medtronic carelink express monitor,
placed in a convenient community location, would allow multiple patients to undergo
remote monitoring. We hypothesise that this would increase patient satisfaction
with pacemaker follow up, reduce wasted appointment time, minimise expenditure
on hospital transport, decrease carbon footprint, and increase availability of on-site
clinics and physiologists. We hypothesise that this would be a safe and effective
method of conducting pacemaker follow up.
Method: A Medtronic
carelink express monitor was placed in a community health centre and a pilot
group of 90 patients were invited to partake in community follow up. Patients
were instructed on how to use the monitoring device and 57 patients were successfully
enrolled. Patients were given an indication of when pacemaker follow up was
required, but exact attendance time was entirely at their discretion. The carelink
monitor was unmanned. Information was sent wirelessly to the hospital and
assessed at a virtual follow up clinic.
Results: 100% of
patients successfully utilised the remote device with a virtual DNA rate of 0%.
No patients required extra assistance in using the equipment at the time of
download. The average time to assess a download was 6 minutes, compared to 15
minutes for an on-site appointment. There were no adverse events during the
follow up period. Average patient travel
time and distance for follow up was reduced. Hospital transport was not
required for any patient. The feedback from patients was positive and based
around ease of travel, length of travel and stay, and flexibility to attend.
Conclusions & Implications:
This pilot study demonstrates the feasibility and benefits of remote pacemaker
monitoring from a community location. This model could be replicated in the
future by other Trusts.
Submitter Details
Dr Benedict Wiles
Authors
Names |
Presenting Author |
Institution |
Dr Benedict Wiles |
Yes |
University Hospital Southampton |
Miss Hollie Cottrell |
No |
University Hospital Southampton |
|