부산대학교 도서관

Purpose: The remote monitoring systems (RMS) in patients (pts) with implantable cardioverter defibrillator (ICD) have already several studies to prove its safety and efficacy, although there are few indicators on satisfaction of patients. The aim of this study was to determine the satisfaction of pts with RMS, thus assessing whether the proven benefits of these systems is accompanied by a good acceptance from pts.Methods: The study included 23 pts in the program of distant monitoring for more than 3 months (Home-monitoring of Biotronik Inc. and Medtronic Carelink inc). Seventy percent of this pts (n = 16) had ICD alone and 40% (n = 7) had ICD combined with cardiac resynchronization therapy (CRT). All pts answered a satisfaction questionnaire to evaluate the easiness of use of the device, the psychological aspects in relation to its presence and overall satisfaction. Four questions were made: A) How would you rate the degree of difficulty installing the monitor; B) How would you rate the degree of difficulty using the device in general; C) How, the ability to be monitored remotely, influenced your state of anxiety about the disease and D) How would you rate your satisfaction with the use of remote device. Each item was rated on a five point scale: from 1, strongly unfavourable, to 5, strongly favourable (total score between 5 and 20). An answer was considered favourable with a score ≥ 4. It was also made the question: 'After this study, which method of visit do you prefer: in-hospital or remote?'.Results: The population consisted of pts with mean age 65±10 years, 65.2% male (n = 15) and 34.8% female (n = 8). The underlying heart disease was ischemic in 65.2% (n = 15) of pts, dilated in 30.5% (n = 7) and hypertrophic in 4.3% (n = 1). The ICD was implanted for primary prevention of sudden death in 87% (n = 20) of pts. In the analysis of the questionnaire, 87% (n=20) answered favourably (score ≥ 4) to question A and B, 74% (n = 17) to question C and 100% (n = 23) to question D. The mean total score was 16.3±1.5. Regarding the preferred method of visit, 43.5% (n = 10) of pts chose in-hospital, 30.5% (n = 7) chose remote and to 26% (n = 6) of the pts was indifferent.Conclusion: Most of our pts have a high level of acceptance and satisfaction with the RMS, reflecting a significant adhesion to this follow-up strategy, with clear advantages in the management of human and economic resources. However, a significant percentage of patients still prefer in-hospital visits, reflecting the importance of the doctor/patient relationship.