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Aktuelle Kardiologie 2012; 1(04/05): 309-318
DOI: 10.1055/s-0032-1315052
Übersichtsarbeit
Georg Thieme Verlag KG Stuttgart · New York

Telemetrie bei implantierbaren Devices: Was ist nötig, was ist sinnvoll?

Telemetric Follow-up of Implantable Electrical Devices
R. F. Bosch
1   Cardio Centrum Ludwigsburg (CCLB)
,
P. Villena
1   Cardio Centrum Ludwigsburg (CCLB)
,
A. Wanner
1   Cardio Centrum Ludwigsburg (CCLB)
,
H. Krause-Allmendinger
1   Cardio Centrum Ludwigsburg (CCLB)
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
16. Oktober 2012 (online)

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Zusammenfassung

Die telemetriegestützte Nachsorge von Schrittmacher-, ICD- und CRT-Systemen ist in vielen Einrichtungen inzwischen tägliche Routine. Alle wichtigen Hersteller der in Deutschland implantierten Aggregate bieten kommerziell verfügbare Telemetriesysteme an. Die derzeit vorliegenden Daten zeigen, dass die telemetrisch gestützte Nachsorge implantierter Aggregate sicher durchgeführt werden kann. Dieses Vorgehen verringert den Aufwand für Patienten sowie die Arbeitsbelastung für die nachsorgende Einrichtung und führt zu einer früheren Detektion technischer und klinischer Probleme. Hieraus resultiert eine hohe Sicherheit für Patienten und eine Verringerung der Hospitalisierungsrate und möglicherweise der Mortalität. Inwieweit dieses Vorgehen in der Lage ist, harte klinische Endpunkte zu verbessern, wird in einer Reihe laufender Studien untersucht. Bisher liegen jedoch keine Standards oder gar Leitlinien zur praktischen Durchführung der telemetrischen Aggregatnachsorge vor. Dies ist jedoch Voraussetzung, um einem breiten Einsatz dieser innovativen Technologie in der täglichen Routine den Weg zu bahnen.

Abstract

Remote-follow-up of implantable pacemaker, ICD- and CRT-devices is already clinical routine in many follow-up clinics. All important manufacturers of the devices implanted in Germany offer telemetry-platform commercially available telemetry-platforms. Scientific data provide evidence that a remote-based follow-up can be carried out safely. It reduces labour for patients and follow-up clinics and allows earlier detection of clinically important events or device-related problems. This results in a higher security for patients, a decrease in hospitalizations and potentially a decrease in mortality. The question whether remote follow-up is able to reduce hard clinical endpoints is currently being studied in several large-scale trials. At the moment, there is a lack of clinical standards or guidelines for remote follow-up of implantable devices. This however, is a prerequisite for the widespread use of this innovative technology in daily clinical practice.

Schlüsselwörter

Herzschrittmacher - implantierbarer Kardioverter-Defibrillator - Telemedizin - Herzinsuffizienz - Arrhythmien

Key words

cardiac pacemaker - implantable cardioverter defibrillator - telemedicine - heart failure - arrhythmias
 

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