SUNDAY, July 28, 2002 (HealthDayNews) -- Heart patients with implantable cardioverter defibrillators (ICDs) now only need to pick up the phone for a check of their lifesaving device.
New technology has made "virtual office visits" an option for the 200,000 Americans with ICDs. Instead of making the standard three monthly trips to their doctors, they can relay information about their defibrillators via phone lines.
ICDs are mechanical heart aids prescribed for people who suffer abnormally rapid and potentially life-threatening heart rhythms.
The device is implanted under a patient's skin in the upper chest area and when an irregular rhythm is detected, the ICD administers an electric shock that returns the heart to its normal rate.
With a "virtual office visit," doctors retrieve and review their patients' defibrillator data via the Internet.
The transmitted data provides readings on the device's mechanics and how a patient's heart has functioned since the last check-up.
"I think at some point this will become the standard way to follow defibrillators," says Dr. Ken Riff, a physician with Medtronic Inc., the company that developed the technology.
While the system won't make office visits obsolete, Riff predicts it will decrease them: "We anticipate doctors seeing patients once a year, with in-between visits done over the Internet."
The new technology means almost everything that takes place during a face-to-face ICD consultation can occur even when the doctor and patient are miles apart.
Here's how it works: Patients collect information by holding a cell phone-like wand over their defibrillator. The wand is wired to a monitor plugged into a standard home phone line. Once the monitor receives the information, it automatically dials up the Medtronic CareLink Network and sends the data. It takes about 10 minutes from the time the wand scans the implant until the readings appear.
By logging on with a secure password, doctors and nurses can read patients' data off the system's Web site.
The system has been running for about six weeks. People who are already hooked up have been advised to prearrange times for their cyber check-ups, Riff says: "They can't merely transmit the information because the doctor may not pick it up for a while."
According to Dr. Masood Akhtar, a physician with Wisconsin Electrophysiology Group Heart Care Associates in Milwaukee, certain problems will make some office visits unavoidable.
"If the data tells you the patient got two or three shocks because the first one didn't work, you may want to increase the energy for the first shock. There are multiple things you may have to do depending on what information you get, but you have to reprogram the device in the office," he says.
Although the technology for remote programming is available, "until everyone's comfortable it can be done remotely, we won't do that," Riff says. "We first have to build up patients' and doctors' confidence in the system."
Akhtar believes patients will welcome this development, especially those who travel long distances for check-ups. Still, he adds, technology will never replace the gut feeling a doctor gets when he sees a patient personally.
"When people come in they might not volunteer information, but when you look at them they appear pale and unwell. You won't pick that up by remote control," he says.
What To Do
To learn more about the remote monitoring of ICDs, visit Medtronic Inc. For more information on heart arrhythmias, go to National Heart, Lung, and Blood Institute.
