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CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg 2021; 69(S 03): e53-e60
DOI: 10.1055/s-0041-1735479
Pediatric and Congenital Cardiology

Telemonitoring with Electronic Devices in Patients with a Single Ventricle Anatomy

Peter A. Zartner 
1   Department of Cardiology, German Paediatric Heart Centre, University of Bonn, Bonn, Germany
,
Nathalie Mini
1   Department of Cardiology, German Paediatric Heart Centre, University of Bonn, Bonn, Germany
,
Diana Momcilovic
2   Department of Cardiology and Pulmonology, University of Bonn, Bonn, Germany
,
Martin B. Schneider
1   Department of Cardiology, German Paediatric Heart Centre, University of Bonn, Bonn, Germany
,
Sven Dittrich 
3   Department of Paediatric Cardiology, University of Erlangen-Nuremberg, Erlangen, Germany
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Abstract

Background A growing number of patients with a single ventricle anatomy, who had a Fontan palliation as a child, are now reaching adulthood. Many need an epimyocardial pacemaker system with an optional telemonitoring (TM) unit, which evaluates the collected data and sends it via Internet to the patient's physician. There are no data on the reliability and clinical relevance of these systems in this patient group.

Methods We analyzed data in 48 consecutive patients (mean age 18 years, standard deviation 9 years) with a Fontan or Fontan-like palliation who received a cardiac implantable electronic device with a TM unit from Biotronik (Home Monitoring) or Medtronic (CareLink) between 2005 and 2020 with regard to the reliability and clinical relevance of the downloaded data.

Results The observation period was from 4 months to 14 years (mean 7 years, standard deviation 3.9 years). A total of 2.9 event messages (EMs)/patient/month and 1.3 intracardiac electrogram recordings/patient/month were received. Two patients died during follow-up. The combination of regularly arriving statistical data and 313 clinically relevant EMs led to the modification of antiarrhythmic or diuretic medication, hospitalization with cardioversion or ablation, and cortisone therapy to avoid exit block in 21 (44%) patients.

Conclusion TM is an instrument to receive functional and physiologic parameters of our Fontan patients. It provides the ability to respond early for signs of system failure, or arrhythmia, even if the patient is not experiencing any problems. It is a useful tool to manage this difficult patient population without frequent hospital visits.

Keywords

Fontan circulation - single ventricle - pacemaker - AICD - total cavopulmonary circulation - epimyocardial - implantation


Publication History

Received: 14 February 2021

Accepted: 02 July 2021

Article published online:
10 December 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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