Cardiac Device Monitoring
What is a cardiac device?
Cardiac devices include pacemakers and ICDs (implantable cardioverter-defibrillators).
Cardiac devices have very advanced features. Your doctor can program your device to work in different ways depending on your needs.
What is monitoring?
Doctors check, or monitor, cardiac devices on a regular basis to make sure that they are working right and aren't causing any problems. Doctors also check the battery to see if it needs to be replaced.
Your doctor can also get information about your heart rate and heart rhythm. Cardiac devices can keep a record of when you had an abnormal heart rate or an irregular heart rhythm. So these devices can help your doctor know how your heart is doing and if you need any changes in your treatment.
Monitoring is done at office visits and remotely. Remote monitoring is done by telephone or the Internet.
Your doctor will check your pacemaker regularly to make sure that it is working correctly and that the settings are right for you. The process of checking your pacemaker settings is called interrogation.
The strength and length of the impulse sent to the heart muscle and how fast the pacemaker will go can be programmed into the pacemaker. Your doctor may adjust the pacemaker programming, if needed.
Your doctor will check your ICD regularly to make sure that it is working correctly and that the settings are right for you.
ICDs can store a lot of information that your doctor will look at. Your doctor will check to see if you had any irregular heart rhythms or if the ICD gave you any therapy (like a shock). If you have had a shock, your doctor will make sure that it was given at the right time and that it didn't happen when you didn't need it.
Monitoring at your doctor's office
No surgery is needed to check your cardiac device. The doctor places a special programming tool directly on your chest (on top of your skin and clothes). The tool automatically sends back information.
Your doctor may check the skin around your implanted device to make sure that there are no signs of an infection.
Monitoring by telephone or through the Internet
In between checkups at your doctor's office, you will probably send information from your cardiac device to your doctor. You will do this by using a telephone or the Internet. This is easier and costs less than going to the doctor's office or clinic every time you need to have your device checked.
To check your device, your doctor will give you a special transmitter to use. You might connect this transmitter to a phone line or the Internet in your house.
You can send information to your doctor in different ways. You might have a scheduled time when you use the transmitter like a telephone and hold a monitor over your chest to send information over the phone. Or your device might send information automatically to your doctor. This can be done while you are sleeping.
Your information is stored securely on the Internet so that only your doctor can see it.
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Other Works Consulted
- Bhargava M, Wilkoff BL (2007). Cardiac pacemakers. In EJ Topol, ed., Textbook of Cardiovascular Medicine, 3rd ed., pp. 1191–1212. Philadelphia: Lippincott Williams and Wilkins.
- Epstein AE, et al. (2013). 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities. Circulation, 127(3): e283–e352.
- Wilkoff BL, et al. (2008). HRS/EHRA expert consensus on the monitoring of cardiovascular implantable electronic devices (CIEDS): Description of techniques, indications, personnel, frequency, and ethical considerations. Heart Rhythm, 5(6): 907–925. Available online: http://www.hrsonline.org/Practice-Guidance/Clinical-Guidelines-Documents/HRS-EHRA-Expert-Consensus-on-the-Monitoring-of-Cardiovascular-Implantable-Electronic-Devices/2008-Monitoring-of-CIEDs.