Case Study: Telemonitoring & Remote evaluation of Arrhytmias and (Cardiac) Conduction in Patient care

Department:

HeartCenter Academic Medical Center
University of Amsterdam (AMC)Supervisors:

Marije Vis, (Interventional) Cardiologist, Department of Cardiology, AMC

Martijn van Mourik, Technical Physician, Department of Cardiology, AMC

Case: Transcatheter Femoral Aortic Valve Implantation (TF-AVI)

Of all heart valve disorders, the stenotic aortic valve is accompanied with the highest burden. Surgical aortic valve replacement (SAVR) is the current standard care. For elderly patients with comorbidities SAVR can be of too high risk. These frail patients can qualify for transfemoral transcatheter aortic valve implantation (TtelemonitoringF-TAVI), a relatively new therapeutic approach to implant a bioprosthesis under local anesthesia only.

Remote home monitoring can identify frailty and might benefit clinical decision making. Furthermore SAVR or TF-TAVI is sometimes complicated by post-procedural cardiac conduction disorders (CCD). Therefore in hospital telemonitoring is mandatory for a minimum of 72 hours after the procedure. Mobile health (mHealth) can have a major impact in medical care by transferring current hospital bound care to a home or remote situation. Additionally, extra services can be added to enhance a patient tailored care trajectory.

For patients it means less risk for hospital acquired complications and early rehabilitation in their own environment. Hospitals gain more capacity leading to a higher productivity. This all contributes to a higher quality of life and a healthcare cost reduction.

Whether telemonitoring is reliable in patientcare is under investigation. The technology is rapidly shifting patient care and is expected to form the basis of patient care in the future.

This workshop is intended for students with a special interest in mHealth. We will demonstrate a taped TF-TAVI procedure and data retrieved from a mobile monitor device. On the basis of this data, participants will discuss and try to find solutions for clinical decision making. Which data are important from a patients and/or doctors perspective? How can we combine different vital parameters in daily patient care? Who is going to pay for mHealth in healthcare systems in the future? At the end of the workshop students will have gained a better insight into the usefulness of mHealth in patient care and what it means for hospital management.