Heart failure algorithms for remote monitoring in people with cardiac implantable electronic devices

Overview

Remote monitoring systems for complex implantable devices have been able to identify unstable parameters in patients with heart failure for several years. However, until now there has been no structured evidence-based pathway to manage the alerts. The heart failure team at Northern Care Alliance were highly interested in supporting the development of a structured evidence-based pathway to ensure heart failure patients receive the best care and benefit from early intervention.

Since the study began in October 2019, a full cross-hospital and community team approach was adopted to develop the skills and knowledge to record and action the alerts appropriately. Engagement from physiologists was key in identifying the caseload for enrolment. The enrolment process was dynamic at the beginning as there was a pool of patients who had historic devices implanted. Current enrolment keeps up with the implants, at the 6-week check with the physiologist, the remote platform access is established, alerts on the device are activated and the details are forwarded to the heart failure team to onboard. This has become business as usual and established care for our cardiac electronic implanted device (CEID) population. The heart failure team uses a monthly rota to nominate responsibility for the transmission reviews, and the reviewer will mail the details to the named nurse for action and recording.