A semi-automatic algorithm for reducing the time spent on routine follow-up of cardioverter defibrillators

Background. The routine follow-up of cardioverter defibrillators (CD) is a time-consuming procedure. Aim of the Study and Methods. The present study was a prospective randomized cross-over evaluation on the clinical usefulness of a specific semi-automatic software algorithm (Quick Check) for CD follow-up, available in CPI Guidant systems (CD and programmer). Time-saving, while ensuring all the required data and patient safety, was evaluated in a large group of patients (105), recruited in different centers. In the same session and under a physician's supervision all patients underwent a follow-up with the aid of Quick Check or a standard follow-up, in a randomized sequence. Each patient served as his own control. Results. In the overall population of 105 patients, the time spent for follow-up was reduced by Quick Check from 186+/-105 sec to 106+/-67 sec (p <0.0001) (43% reduction). The reduction in time spent for follow-up with Quick Check was the same (43% reduction) in patients with detected episodes (n=38) (from 241+/-144 sec to 138+/-95 sec (p <0.0001)) and in patients without detected episodes (n=67) (from 154+/-52 sec to 88+/-34 sec (p <0.0001)). No adverse events or deletion of potentially useful data was detected by the supervising physician. Conclusions. Use of a specific software algorithm for routine follow-up of implanted CDs allows a significant shortening of the time spent on routine follow-up, thus reducing costs. The supervision of a physician is a guarantee of patient safety.