Are You Being Followed by Telephone?

Having had one of my family members receive a device, I was shocked (no pun intended) to see that see was not being followed by remote follow-up. Her physician's office didn't have anyone adequately trained. Remote Follow-up provides a wealth of information.

I have worked with 3 out of the 5 device companies for 20+ years, and know of a great company that provides this service to cardiologist's offices. If your cardiologist is not providing this service for you, contact me directly and I will send them info.

David Starnes
davidstarnes1@gmail.com
832.428.7672

7 Comments

Look closer Patch

by Grateful Heart - 2014-12-05 08:12:29


They might be little green phones.

Grateful Heart

Is it just possible that ...

by IAN MC - 2014-12-06 04:12:46

having worked for 3 out of 5 device companies you are now working for a company which provides remote follow-up ??

Overrated

by golden_snitch - 2014-12-06 07:12:23

Hi!

There is no convincing study data, yet, suggesting that remote monitoring is of any benefit for pacemaker patients with single- or dual-chamber devices. For CRT and ICD patients, yes, but not for the standard pacemaker patient who just has a block or a lazy sinus node. In Germany, I do not know of any pacemaker patients being followed by remote monitoring, only ICD and CRT patients. Our guidelines state that it might be taken into consideration for pacemaker patients who, for instance, have a lead with a rising threshold or changing impedance. But it's not generally indicated for each and every pacemaker patient. Today's pacemakers can automatically adjust to changing thresholds. And the battery usually does not deplete in a way that you need to watch it all the time; going in every 6-12 months is usually totally sufficient.

Remote monitoring can certainly come in handy when it detects episodes of atrial fibrillation that the patient does not feel. But, hey, not every patient develops Afib. Especially for the younger pacemaker patients this is nothing that one has to watch out for all the time. With rising age, this changes - about 12% of all people aged 80+ have Afib -, but there is still a great majority that does not get Afib. If you want to properly diagnose all patients at higher risk for Afib, you'd have to monitor ALL people that age, not just the device patients.

So, in my opinion this whole remote monitoring thing is a bit overrated in the standard pacemaker patient. I know that one study was presented at either HRS sessions or ACC sessions this spring, and it claimed that remote monitoring was good for these patients, but then it did not explain why patients not being followed by remote monitoring had a greater mortality rate. So, it's not said that this had anything to do with the pacemaker and being followed or not. The study did not indicate that pacemaker patients not being followed died because of Afib that wasn't caught in time. There was just this higher mortality and the presenters of the study not explaining it.

Inga

Of course

by golden_snitch - 2014-12-06 08:12:29

Totally agree with you, Ian. Though a study like that would be beneficial for any doctor or tech, no matter from which of the manufacturers he/she might be receiving grants, because nowadays they ALL offer remote monitoring.

I think it's good that my pacemaker has remote monitoring, so that it can be activated in case I should ever need it. Recently got to know a photographer who travels all over the world, and often to regions like the Artic etc., so for her remote monitoring is great. But I'm perfectly fine seeing my cardio every 6-12 months, at least for now.

Inga

Also Inga

by IAN MC - 2014-12-06 08:12:59


It is worth bearing in mind that the author of the study which suggests that remote monitoring can save lives received consulting fees and cash honoraria from St Jude .

Could this possibly have affected his objectivity ? Would he still have received cash payments if his results had not been favourable to remote monitoring ? Sorry if I sound cynical but I spent most of my life working in the drug industry !!

More studies need to be done.

I agree with your comment that if you have a PM ( rather than a CRT or ICD ) then there is little reason to have remote monitoring . I guess if you live hundreds of miles from your PM guru it does add some convenience but otherwise, I don't see the point.

Ian

don't have it, don't want it

by Tracey_E - 2014-12-07 01:12:54

If I had more serious problems or lived in a remote area, maybe, but I like talking to the rep and nurses in the office. It's 15 min a few times a year, small investment of my time to get a report what's going on. I would not want to change that.

Monitoring

by Artist - 2014-12-08 05:12:14

I am 32 days post op and have a St. Jude PM. I got the remote monitoring equipment about a week ago. If I understand it correctly they only actually monitor a person at selected intervals (not continuously) and supposedly supply a schedule of when they will be performing a monitoring session. The voltage on my PM is still turned up pretty high. I am assuming that the monitoring reads the PM and shows information regarding how much of the time the PM is "kicking in" and how fast the battery is draining and provides information regarding adjustments that might be needed before a routine follow up appointment is made. I see my EP on January 7th, so unless they perform a check before that appointment that results in the need to move that appointment up, I will have to wait to quiz the doctor on the need for remote monitoring.

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