Device alert: elective replacement indicator

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N° 5
Manufacturer Biotronik Device Remote monitoring Field Messages and events
Patient

This 44-year-old man received a Lumos VR-T single chamber defibrillator for primary prevention of idiopathic cardiomyopathy with a left ventricular ejection fraction of 20%; regular telemedicine follow-ups. 
Graph and trace

Telemedicine report

Regular evaluations over time (MOL 1 and  MOL 2) of the battery status by telemedicine. BOL = beginning of life, MOL1 = midlife 1, MOL 2 = midlife 2.

An alert was delivered (RED status) when the elective replacement indicator (ERI) was reached, which can be caused by 1) a battery voltage below the threshold value (for this defibrillator model = 5.7 V), 2) a measurement of the current continuously below the threshold, indicated by an energy gauge posted at 0%, or 3) charge time of the capacitors >20 sec.

Comments

Telemedicine optimizes the management of the devices’ end of life. Before telemedicine became available, when the indicators indicated that the end of battery life was approaching, the frequency of follow ups was increased along with the anxiety of some patients. Teleconsultations enable a follow-up of the battery depletion without increasing the number of visits, which offers several advantages, including

  1. reassurance and greater autonomy of the patient,
  2. lower cost related to the repetitive transportation for ambulatory visits,
  3. avoidance of a) premature device replacements, and b) dangerously approaching the end of battery life by missing the ERI.
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