Sudden cardiac death is responsible for one-third of coronary artery disease deaths in women, and the reason why women with heart disease and recurrent heart arrhythmias are prime candidates for implanted cardioverter defibrillators (ICDs). In addition, pacemakers are implanted in nearly 100,000 women each year to treat symptomatic bradycardia (abnormally slow heart rate), according to Raytel Cardiac Services, headquartered in Hartford, Connecticut.

However, as the number of ICD and pacemaker recipients grows, so does the need for new ways to monitor and assess these devices on a regular basis, a key factor in assuring the sustained effectiveness of the devices. Now, new “telemedicine” technology is available for ICD and pacemaker patients to remotely monitor these devices from the comfort and convenience of home or anywhere there is a telephone line.

“Remote monitoring of ICDs is an excellent service for patients,” says Lawrence Gessman, M.D., cardiologist and electrophysiologist at Cooper University Hospital in Camden, New Jersey, and a member of the Raytel Medical Advisory Board.

“Telephone follow-up is an accepted practice in pacemaker care, and a study by the Cleveland Clinic (Journal of Interventional Cardiac Electrophysiology, November 2004) demonstrates that there are significant benefits for the ICD population as well. If the patient is shocked at home, the information is downloaded and transmitted to the physician after the shock episode so an immediate assessment can be made, preventing unnecessary visits to the emergency room.”

Gessman adds, “The findings of the ‘Sudden Cardiac Death in Heart Failure Trial’ (SCD-HeFT) study (New England Journal of Medicine, January 20, 2005), demonstrates that ICDs save lives among people at risk for sudden cardiac death, and as a result, remote monitoring with a service like Raytel’s is likely to be the only way doctors will be able to manage the ongoing follow-up of all these new patients in a timely and comprehensive manner.” Presently, there are only 3,700 specialists in cardiac pacing and electrophysiology in 64 countries, according to the Heart Rhythm Society.

Raytel Cardiac Services, a leader in the field of remote monitoring of pacemakers for more than three decades, now offers doctors and patients the most efficient, reliable solution for managing the routine and emergency follow-up of the rapidly growing numbers of these ICD devices. The benefits of remote monitoring of ICDs and pacemakers for patients, include:

• Patients test from home and don’t have to travel long distances for follow-up care.
• nnecessary visits to the doctor and emergency room after a shocking episode are avoided with remote follow up.
• Patients who experience a shock or any symptoms can call the Raytel ICD center 24/7, 365 days per year, with confidence that someone will be at the other end of the phone.
• If a cardiac event does occur that requires the patient to go to the hospital for emergency care, Raytel will send the ICD report to the ER physicians, speeding up triage.
• Raytel works directly with insurance companies and HMOs on the patient’s behalf.
• Remote monitoring enhances a patient’s quality of life: in the Cleveland Clinic study, patients on remote monitoring expressed an average 96% satisfaction rating.
• Remote monitoring is simple to learn and administer; a convenient service via a standard phone line.

In light of recent recalls by Guidant and other manufacturers of ICDs, Raytel’s ICD remote monitoring program offers peace of mind to both patient and physician, since the service can detect a wide range of problems and situations that can adversely affect the device and its ability to function properly. These include:

• Detecting battery problems such as battery weakness and deterioration
• Detecting issues with the device’s lead - the wire through which electrical voltage passes through to shock the heart back to a normal rhythm
• Detecting device malfunctions, such as misinterpretation of heart rhythms
• Determining if the device is programmed correctly for the individual patient(reprogramming suggestions are forwarded by Raytel to the patient’s physician, pending physician approval)
• Logging the rate of heartbeats over time for various assessments
• Recording the amount of voltage used to shock the heart back to a nomal rhythm during an episode
• After an episode, remote monitoring can detect the cause of the shock, and, with the physician, determine if the patient needs to go to the emergency room. If so, the information is forwarded to the ER and the physician prior to the patient’s arrival - since many smaller hospitals are not equipped to evaluate ICDs, this information is critical to efficient and effective patient management