The Latest Device Therapy in W. Herts

Dr Philip Moore

Pacemaker implants

ICD implants Europe 2005-8

ICD implants

CRT

ICD

Who gets an ICD?

Who gets CRT?

NICE guidance for Cardiac Resynchronisation Therapy (CRT) (Technology Appraisal 120 2007)

(CRT-P) is recommended as a treatment option for people with heart failure who fulfill ALL the following criteria:

• They are receiving optimal pharmacological therapy for Heart Failure• They are currently experiencing or have recently experienced NYHA class III–IV symptoms.• They have a left ventricular ejection fraction of 35% or less.• They are in sinus rhythm:

either with a QRS duration of 150 ms or longer estimated by standard ECG

or with a QRS duration of 120–149 ms estimated by ECG and mechanical dyssynchrony that is confirmed by echocardiography.

Patient Pathway

Patient meets criteria?

Devices clinic

Pre-implant counselling

Device Implant

Follow-up

Automatic Remote Device Follow-up

1. Clinic staff can preschedule the automatic device checks for each patient

2. The device automatically “wakes up” at the scheduled time and communicates with the Medtronic CareLink Monitor. Data are transferred automatically & silently as the patient sleeps

3. Data are transferred to a secure server via the patient’s standard phone line

4. The clinician reviews the patient’s device data on the secure website

CareLink Patient Monitor