IN THIS ISSUE

Daily Living

Device Monitoring: Understanding What’s Right For You

Talk to your doctor about important safety information.

Everyone with an implantable heart device should have regular monitoring to make sure their device is working properly with their condition. Many people wonder, “Why are there so many different types of monitoring systems? Why do I use one monitoring system for my device, while someone else I know uses a different system?”.

The technology behind implantable heart devices has changed greatly since the first pacemaker was implanted in 1960. Similarly, technology has also greatly changed the way health care professionals monitor devices.

There are three main factors that determine what type of monitoring system your doctor will prescribe for you:

• The type of device you have

• The manufacturer of your device

• What you and your doctor decide is the best approach for you

1. Type of device

Implantable heart rhythm devices include pacemakers, implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy (CRT) pacemakers and defibrillators. The devices all use similar digital technology. However, each is designed to treat a specific heart condition. The devices have different features and use a variety of monitoring systems.

ICDs and CRT-D devices: If you have a certain model of an ICD or CRT defibrillator, you may be able to use in-home (remote) monitoring. Remote monitoring is the newest type of monitoring available for devices. The LATITUDE® Patient Management system from Boston Scientific is one example of remote monitoring for ICDs and CRT defibrillators.

In-home monitoring typically uses a piece of equipment that sits on a nightstand or small table. It may send information over your landline phone to a secure website that can be viewed by your doctor or health care team.

For example, the LATITUDE system can send information about your implanted device, such as how much energy is left in the battery. If your implanted device delivered shock therapy, its digital memory stores information about what your heart rhythm was doing before, during and after the therapy, the LATITUDE system can notify your doctor that the event occurred.

An in-home monitoring system like the LATITUDE system helps your health care team deliver a higher standard of care through remote monitoring between office visits. It can help give you peace of mind, knowing that your device can be checked more frequently, and confidence, knowing your doctor will be alerted if specific device conditions exist.

Pacemakers and CRT Pacemakers: Patients with pacemakers from certain manufacturers may use in-home remote monitoring. Trans-telephonic monitoring (TTM) is also common for pacemakers and CRT pacemakers.

TTM is a more traditional type of monitoring system that also uses a landline phone. TTM converts signals from a pacemaker into sound waves and sends them over the phone. The monitoring station at the other end of the phone receives the sound wave signals and converts them back into the original signals in the form of an electrocardiogram (ECG) or heart rhythm recording.

Device manufacturers do not provide TTM services directly. Your clinic may provide these services or contract for TTM with other companies that provide this service.

2. The manufacturer of your device

There are several different manufacturers of implantable heart devices. Each uses its own proprietary technology. When doctors implant a device, they consider the manufacturer and model of device that will be the best match for each patient's particular condition.

Each manufacturer's devices and monitoring systems must meet very stringent requirements and earn the approval of the U.S. Food and Drug Administration (FDA). A manufacturer's monitoring system is designed to work only with their devices. For example, if you have a Boston Scientific device, your device cannot use a remote monitoring system from another manufacturer.

While each manufacturer's monitoring systems are similar, differences do exist. Talk to your doctor about which system is right for you.

3. What you and your doctor decide is the best approach for you

The most important factor that determines the monitoring system you will use for your device is what you and your doctor decide.

“Every person is different,” explains Melanie Gura, RN. “Some people may have hesitations about using a remote monitoring system. Patients have expressed concerns such as not wanting to see a daily reminder of their heart condition with a remote monitor on the nightstand when they wake up every morning. But once they try it, most people discover that the system works great and is easy to use. They find they really like the convenience.”

Adjusting to a remote monitoring system can be similar to adjusting to getting an implanted device. “At first, you may think about it every day. But then in three or four months you begin to accept it as a normal part of your life,” said Gura.

“Many people like the convenience of not having to come in as often for appointments. Others like the face-to-face contact and personal connection that they have when they visit their clinic. So most clinics give patients a choice about how they want to use remote monitoring,” added Gura.

Talk to your doctor about important safety information.