open access

Vol 25, No 1 (2018)
Original articles — Clinical cardiology
Published online: 2017-06-20
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Effectiveness of Medtronic CareLink Express System in identifying patients with high-energy electrotherapy devices requiring clinically significant intervention

Marcin Grabowski, Sabina Sadecka, Andrzej Cacko, Marcin Michalak, Leszek Blicharz, Paweł Balsam, Grzegorz Opolski
DOI: 10.5603/CJ.a2017.0071
·
Pubmed: 28653315
·
Cardiol J 2018;25(1):81-86.

open access

Vol 25, No 1 (2018)
Original articles — Clinical cardiology
Published online: 2017-06-20

Abstract

 Background: The number of patients with implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy and defibrillator (CRT-D) is growing. This results in high workloads for centers performing standard controls (SC) of these systems. Medtronic CareLink Express® (MCLE) is a solution enabling remote controls (RC) of implantable devices. In cases of detecting arrhythmias or device malfunctioning, it automatically generates alarms transmitted to the controlling physician. The objective of the study was to evaluate the effectiveness of alarms generated by MCLE in identification of patients that require clinically significant intervention during SC.

Methods: A total of 119 patients (age 64 ± 14, 17 women) implanted with ICD/CRT-D were included in the trial. Device reprogramming or pharmacological treatment modifications during SC were as­sessed as significant if they were required for optimal clinical management of the patient (effectiveness of antiarrhythmic and resynchronization therapy, also patient safety). Analysis of generated alarms was then performed to assess the effectiveness (sensitivity and specificity) of MCLE in identifying patients that require changes in therapy.

Results: Data from 129 transmissions and 129 subsequent SCs were analyzed. 179 alarms were recorded during 96 (74%) transmissions. A total of 333 program changes of implanted devices took place during 107 (83%) SCs. Device reprogramming was considered clinically significant in 27 cases Additionaly, 13 pharmacological treatment modifications were performed. Sensitivity and specificity of alarms generated by MCLE with regards to identification of patients requiring clinically significant intervention was 87% and 31%, respectively. Finally, a statistically significant difference was observed in the number of clinically significant interventions among patients with and without MCLE alarms (33 [86.8%] vs. 5 [13.2%], p = 0.037).

Conclusions: Medtronic CareLink Express® is an RC system enabling high-sensitivity supervision of patients with cardiac

Abstract

 Background: The number of patients with implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy and defibrillator (CRT-D) is growing. This results in high workloads for centers performing standard controls (SC) of these systems. Medtronic CareLink Express® (MCLE) is a solution enabling remote controls (RC) of implantable devices. In cases of detecting arrhythmias or device malfunctioning, it automatically generates alarms transmitted to the controlling physician. The objective of the study was to evaluate the effectiveness of alarms generated by MCLE in identification of patients that require clinically significant intervention during SC.

Methods: A total of 119 patients (age 64 ± 14, 17 women) implanted with ICD/CRT-D were included in the trial. Device reprogramming or pharmacological treatment modifications during SC were as­sessed as significant if they were required for optimal clinical management of the patient (effectiveness of antiarrhythmic and resynchronization therapy, also patient safety). Analysis of generated alarms was then performed to assess the effectiveness (sensitivity and specificity) of MCLE in identifying patients that require changes in therapy.

Results: Data from 129 transmissions and 129 subsequent SCs were analyzed. 179 alarms were recorded during 96 (74%) transmissions. A total of 333 program changes of implanted devices took place during 107 (83%) SCs. Device reprogramming was considered clinically significant in 27 cases Additionaly, 13 pharmacological treatment modifications were performed. Sensitivity and specificity of alarms generated by MCLE with regards to identification of patients requiring clinically significant intervention was 87% and 31%, respectively. Finally, a statistically significant difference was observed in the number of clinically significant interventions among patients with and without MCLE alarms (33 [86.8%] vs. 5 [13.2%], p = 0.037).

Conclusions: Medtronic CareLink Express® is an RC system enabling high-sensitivity supervision of patients with cardiac

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Keywords

arrhythmic event, heart failure, high-energy electrotherapy devices, Medtronic CareLink Express, remote control

About this article
Title

Effectiveness of Medtronic CareLink Express System in identifying patients with high-energy electrotherapy devices requiring clinically significant intervention

Journal

Cardiology Journal

Issue

Vol 25, No 1 (2018)

Pages

81-86

Published online

2017-06-20

DOI

10.5603/CJ.a2017.0071

Pubmed

28653315

Bibliographic record

Cardiol J 2018;25(1):81-86.

Keywords

arrhythmic event
heart failure
high-energy electrotherapy devices
Medtronic CareLink Express
remote control

Authors

Marcin Grabowski
Sabina Sadecka
Andrzej Cacko
Marcin Michalak
Leszek Blicharz
Paweł Balsam
Grzegorz Opolski

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