Should physicians instead of industry representatives be the main actor of cardiac implantable electronic device follow-up? (super follow-up)
Anatolian Journal of Cardiology, cilt.18, sa.1, ss.23-30, 2017 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 18 Sayı: 1
- Basım Tarihi: 2017
- Doi Numarası: 10.14744/anatoljcardiol.2017.7374
- Dergi Adı: Anatolian Journal of Cardiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.23-30
- Anahtar Kelimeler: cardiac resynchronization therapy, follow-up, implantable cardioverter-defibrillator, optimization, pacemakers, programming errors
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: This retrospective study sought to research the adequacy of the follow-up and optimization of cardiac implantable electronic devices (CIEDs) performed by industry representatives. Methods: A total of 403 consecutive patients (35% females; median age, 67 years; age range 18–97 years) with either pacemakers (n=246), implantable cardioverter-defibrillators (ICDs), (n=117) or cardiac resynchronization therapy with defibrillator (CRT-D) (n=40) applied to our hospital’s outpatient pacemaker clinic for follow-up. These patients had been followed up by industry representatives alone until September 2013 and then by a cardiologist who is dealing with cardiac electrophysiology and has a knowledge of CIED follow-up. Results: It was ascertained that 117 (47.6%) of 246 patients with pacemakers had a programming error. Forty-three (36.8%) of 117 patients were symptomatic, and after reprogramming, all symptoms diminished partially or completely during the follow-up. Moreover, 30 (25.6%) of 117 patients with ICDs had a programming error. Furthermore, 6 (15%) of 40 patients with CRT-Ds had a programming error. To conclude, when all patients with CIEDs were assessed together, it was ascertained that 153 (38%) of 403 patients had programming errors. Conclusion: The prevalence of inappropriate programming of CIEDs by industry representatives was quite higher than expected. Therefore, our study strongly demonstrates that CIED follow-up should not be allowed to be performed entirely by manufacturers’ representatives alone.