What is the remote control of subcutaneous defibrillators (S-ICD) for: the detection of the "atrial fibrillation” or other arrhythmias

La atrial fibrillation it is the most common arrhythmia that patients with cardiomyopathy can present especially after the age of 40. Starting with the A219 model, Boston Scientific subcutaneous defibrillators (S ICDs) recognize and memorize certain arrhythmias. For example, if the heart switches from “sinus rhythm” to “atrial fibrillation” for at least 6 minutes and even several hours, the arrhythmia is recorded in the memory of the S-ICD.

The S-ICD patient who has been equipped with the "remote control" device will periodically carry out data transmissions to send the recordings made by the S-ICD to the Control Center. The transmissions will be made manually by the patient by pressing the appropriate button on the remote control device. The period between one transmission and the next will be established with your Health Center, usually once a week. Once the data has been received and analyzed, the Control Center will notify the operator of the conditions that require attention and which are indicated as “Yellow Alert” and “Red Alert” respectively.

These alarms are displayed by the operator responsible for monitoring the transmitted data (nurse, doctor or technician). In well-organized centres, the check usually takes place daily. However, it must be considered that, if we consider the weekends, sometimes the viewing of the broadcasts takes place in the following 24-48 hours. Unfortunately, for organizational reasons it is not certain that all the centers respond within the times indicated which, in this case, could be significantly longer.

Any recorded arrhythmias, such as atrial fibrillation, are transferred from the S-ICD to the Center - via the remote control device - and generate a "yellow" alarm in the system.

The health operator in charge analyzes the data received and, if he identifies that it is atrial fibrillation, warns the patient and invites him to contact his cardiologist or the reference health center, for any modification of his therapy or for other measures .

However, it should be remembered that "yellow alarms" can also be generated, for example by the recording of episodes of untreated ventricular arrhythmias or by defibrillator discharges. They are also generated when the battery is close to depletion.

A "red" alarm, on the other hand, is generated in relation to a probable malfunction of the S-ICD, in the event of battery discharge or malfunction, such as to limit or block its ability to deliver a shock to stop any sustained ventricular arrhythmia. When the healthcare operator detects a "red" alarm, he contacts the patient as soon as possible to communicate that there is a problem and immediately calls him back to check.