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Cybernetic Guardians: Revolutionizing Cardiac Care through Remote Monitoring of Implantable Devices
Session:
Sessão de Posters 16 - Arritmologia
Speaker:
Adriana Rei Pacheco
Congress:
CPC 2024
Topic:
C. Arrhythmias and Device Therapy
Theme:
04. Arrhythmias, General
Subtheme:
04.6 Arrhythmias, General – Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
Adriana Rei Pacheco; Andreia Fernandes; Pedro Cardoso; Simão Carvalho; Carlos Costa; Tiago Aguiar; Raquel Ferreira
Abstract
<p>Remote Patient Management (RPM) of individuals with implantable cardiac devices allows the clinician to monitor dysrhythmic events in these patients on a daily basis. Our aim was to assess whether the presence of non-sustained ventricular tachycardia (NSVT) alerts, device therapies or a decrease in the percentage of biventricular pacing (%BIV) would be a predictor of hospitalizations or visits to the emergency department (ED), due to cardiovascular events, heart failure or cardiac death.</p> <p>The sample consisted of 100 patients (77% men), aged between 40 and 83, and an average age of 67.98 (SD=9,792), with Implantable cardioverter-defibrillators (ICDs) or Cardiac Resynchronization Therapy devices (CRT), in remote monitoring program. To assess whether the existence of NSVT or therapies after device enrollment predicted the visit to the emergency department, a Binary logistic regression was performed, with therapies and NSVT as predictors and the visit to the emergency department as the dependent variable. The results of this analysis showed that the existence of therapies was a significant predictor of visits to the emergency department, however the same did not happen with the NSVT. Additionally, even with only one significant predictor, the model had an area under the curve of 0.720. The type of prevention (primary vs secondary) significantly predicts the existence of therapies, with patients who placed the device for secondary prevention having a higher probability of therapies. In addition to therapies, the drop in the percentage of BIV was also a significant predictor of visit to the emergency department after enrollment, with patients who had a drop in the % of BIV having a greater probability of going to the emergency department. The type of prevention was also a significant predictor of post-enrollment hospitalization, with patients who placed the device for secondary prevention having a higher probability of hospitalization.</p> <p>Device therapy, namely ICD shock, is a significant event in the patient's life, leading him to resort to the emergency department. Remote monitoring is a useful tool in managing patients with NSVT episodes that would otherwise go unnoticed. Timely therapeutic intervention in patients with alerts due to a decrease in %BIV may prevent visits to the emergency department.</p>
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