73-year-old woman implanted with a Lumax VR-T DX single-chamber ICD for primary prevention of ischemic cardiomyopathy with ejection fraction of 28%, followed by telecardiology; alert message.
Alert message (red color status) for an abnormal out-of-range shock impedance measurement (< 30 Ohms or > 100 Ohms); the shock impedance is measured at 105 ohms; as seen on the curve, this impedance was stable at first (around 80 ohms, which is slightly high but acceptable for a single-coil lead) and then increased relatively rapidly to exceed the threshold of 100 ohms, which justifies an alert message; the right ventricular pacing impedance is within normal limits with a slight increase in its value over the last few days; the quality of the sensing and right ventricular pacing remains perfectly normal without any recent variation in measured values.
This example illustrates one of the challenges encountered with remote monitoring. Telemedicine allows highlighting this shock impedance value deemed abnormal. It also enables the monitoring of the dynamics of these parameters. In this patient, the value exceeds the programmed limit, prompting the issuing of an alert message. Several options are possible:
Telemedicine allows a close monitoring with daily controls when an abnormal value is detected although not justifying a re-intervention as such.
