152 KB23 KB192920262005Schrader, JürgenWallbrück, Karstenletnik:74str. I-75 - I-78številka:suppl. 1ISSN:1318-0347COBISSID_HOST:19269849URN:URN:NBN:SI:doc-WE1Y5DNYenSlovensko zdravniško društvoZdravniški vestnikAtrial FibrillationCardiac Pacing, ArtificialDefibrilatorji, vsadekDefibrillators, ImplantableHeart Failure, CongestiveHospitalizacijaHospitalizationPreddvorna fibrilacijaSrce, odpoved kongestivnaSrčno vzpodbujanje, umetnoPatient benefit from seamless implant monitoring| Nenehno monitoriranje - ali koristi bolniku?|Background. Patients with electrostimulation devices visit the hospital regularly for follow-up. The workload of out-patient departments is ever increasing, but a less frequent check-up is unwanted, as it could impair reliability and effectiveness of the therapy. A system of remote patient monitoring might improve this situation by enabling identification of patientswho benefit from a shortened time for corrective action after any undesired event. A completely automatic system for patient remote monitoring has been introduced (BIOTRONIK Home Monitoring, HM). Daily patient and device data are display on an internet site which allows authorized persons to followthe parameters trends. Several clinical studies are presently being conducted to investigate the benefit of HM in pacemaker and implantable cardioverter/defibrillator therapy. Preliminary results show the systems ability to individualize implant therapy for the patients and the physicians benefits. Previous studies in heart failure (HF) therapy have shown that hospital readmission rates, hospitalisation duration and also mortality can bereduced by patient monitoring programs. A recently started study investigating HM in heart failure therapy aims to define a HF-indicator that predicts a worsening of the patients status leading to hospitalisation. With such an indicator, the responsible physician could be alerted and the patient can be called in. Although several issues connected to Home Monitoring remain to be solved, the time has come for a more flexible patient management. The incorporation of modern information technology into cardiovascular implants offers a way to solve the conflict between limited resources and high quality medical therapy for an aging populationIzhodišča. V starajoči so populacji narašča število pacientov z napravami za elektrostimulacijo srca, ki se morajo redno vračati v ambulanto na kontrolo. Zaradi tega neprestuno narašča delovna obremenitev kardioloških ambulantnih oddelkov. Redkejši pregledi pacientov bi zmanjšali zanesljivost in učinkovitost zdravljena in so zato nezaželeni. Prepoznavanje: pacientov z nevarnimi epizodami na daljavo bi lahko zmanjšalo obremenitev zdravnikov v ambulantnih oddelkih in hkrati omogočilo hitro reakcijo pri bolnikih, pri katerih se pokaže potreba po spremembi zdravljenja. Vključevanje sodobne informacijske tehnologije v srčne vsadke ponuja dober kompromis uporabe omejenih sredstev in sočasne zahteve po visoko kakovostnem zdravljenju. Sistemza avtomatično kontrolo pacientov na daljavo, ki dnevno spremlja stanje pacienta in naprave za elektrostimulacijo (BIOTRONIK Home Monitoring, HM) zbira podatke na internetni strani, kjer so dostopni pooblaščenim strokovnjakom. Prednosti HM pri spremljanju pacientov s srčnimi spodbujevalniki in implantibilnimi defibrilatorji se proverjajo v več kliničnih raziskavah v teku. V prispevku povzemamo njihove preliminarne rezultate, ki opisujejo zmožnost sistema za individualizacijo pogostosti pregledov v dobro pacienta in zdravnika. Pri pacientih s srčnim popuščanjem pogosto spremljanje s strani zdravstvenega osebja dokazano zmanjša število ponovnih hospitalizacij, dolžino hospitalizacije in celo smrtnost bolnikov. V nedavno začeti raziskavi želimo ugotoviti, ali lahko s pomočjo podatkov, zbranih s HM, napovemo ponovno hospitalizacijo. (Izvleček skrajšan na 2000 znakov)TEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo