The CM will get on the GPRS network, part of the 2G-3G mobile telephone
network, and send the reports it receives from the implanted device to
the data center in
Germany. The data center will then make the reports available to the
medical center personel, typically a nurse or a technician, who will
scan them and alert the cardiologist as needed. The daily report is
typically scheduled to be transmitted by the implanted device at 01:00.
Emergency reports, when an arrhythmia
has been detected and/or treated, and any unusual functioning are sent
as they occur. The implanted device will try to send these
reports as soon as it can communicate with the CM unit, and similarly
the CM unit will try to forward them to the data center as soon as it
can get online.
An
example of a
report
following an episode of ventricular fibrillation can be found following
the link. This is a realistic report used for training. The graphs
summarize the recent past and allow the cardiologist an
assessment of any change in the status of the patient.
Since the CM unit needs to send data through the telephone network, the
units must be licensed in the country where it is offered for sales.
But just like you can take your GPRS smart phone anywhere in the world,
as long as it is compatible with the local cellular network (the only
countries in doubt are Japan and Korea), you can travel anywhere in the
world and still be followed daily (if you change time zone,
before
your trip, you may want to ask a company technician to change the
transmission time). If
GSM is available,
then the CM will operate fine. Below are the countries currently
licensed to supply Home Monitoring
In Asia Home Monitoring
is available in China (with >3000 patients monitored), India,
Japan, Hong Kong, Singapore and Vietnam.
Once you have joined Home Monitoring, you can travel the world (posibly
with the exception of Japan and Korea. Their telephone networks do
not support
GPRS) and your
cardiologist can still monitor the device.
What are the benefits of Home Monitoring?
- daily monitoring of the basic functions
- regular (2-3 months) intracardiac electrogram
- as needed alerts of events
Above are the components of the reports from a Lumax 300 HF-T. More
extensive diagnostics will be available with advanced devices.
One of the limitations of care in Asia has been the difficulty to get
regular followups by an experienced technician. Home
Monitoring overcomes this obstacle
since daily followup reports are generated by the system.
One of the Home Monitoring advantage that Systolic Medical offers, is
that the reports are reviewed by our Technical Director with >20
years of experience with CRM devices. He has extensive
design and clinical experiences with Biotronik CRM products, having led
design teams for Biotronik and having been associated with our CRM
business
in Vietnam since 1995.
We have reported at Vietnamese National Congress in
October 2012, of our experience with one Lumax 300 HF-T (CRT-D) patient.
We started monitoring this patient in March 2011. Prior to this, he had
experienced 16 episodes of tachyarrhythmia, with 4 shocks delivered.
The implanting cardiologist did the followups. At the start of Home
Monitoring, we were concerned about the large number of episodes in
this patient. Following him over the next 4 months, his situation got
worse, in spite of changes in the programming device and his Rx. By
mid-July 2011, he had experienced 15 additional episodes of
tachyarrhythmias. We finally were able to diagnose the reason for this
condition and the device was reprogrammed accordingly. Since then, now
over a year, he
has only experienced a few episodes. The large volume of data available
from Home Monitoring was instrumental in the successful resolution of
this patient condition.
Oct
2013. We reported at the Vietnamese Heart Rhythm meeting held in
Da Nang, of an instance we have been able to avert a hospital stay for
a patient who is about to have an acute congestive decompression
episode.
Through
monitoring his nightly heart rate (indication of acute decompression:
nightly heart rate of > 80 bpm), his thoracic impedance (a
significant decrease) and his activity (relatively low level), we
determined that he has the early signs of an acute decompression and
alered his cardiologist. With a focused treatment, the patient was able
to resolve the decompression without the need for a hospital stay.
This is the type of monitoring and resolution you can expect with any
system supplied by Systolic Medical, with our Technical Director
working together with your cardiologist.
So, if you are wearing either a BIOTRONIK defibrillator with the T
option,
or any of the newer pacemakers with the T option, then a
Systolic Medical supplied Biotronik Home Monitoring solution can be
made available to you to enable you to enjoy the level of follow-ups
that European and Americans have enjoyed. Since the CM is an external
device, there is no medical procedure involved. Just a visit to the
company office to pick up the unit and for us to verify your implant.
If you believe Biotronik Home
Monitoring can be of help, please do not hesitate to get in touch with
us, preferrably by e-mail.
Benefits of Home Monitoring
You may be wondering what are some of the benefits of Home Montoring,
besides some of the examples above? In a recent presentation at HRS2014
(Heart Rhythm Scientific Sessions, May 2014, San Francisco, USA, the
largest cardiac rhythm meeting in the world), Mittal and colleagues
presented the result of a study of 262,564 patients who participated in
a study of remote monitoring using a St Jude system (which only
transmit weekly report, as opposed to Home Monitoring with daily
reports) about patient survival.
As you can observe in
the above graphs, with Home Monitoring (which would be equivalent to
the RM Adherence High) there is an across the board reduction in
mortality of >50%! This is the real advantage of Home
Monitoring!
This is why remote monitoring is widely used in the US and in Europe.
And with Biotronik being the pioneer, with operating systems since
2001, you will be in good hands!
Please
do not hesitate to drop us an e-mail if you would consider a cardiac
rhythm management device (pacemaker, defibrillator) with Home
Monitoring.
