Abstract：
Cardiac implantable electronic device (CIED) remote transmissions are an integral part of longitudinal follow-up in pediatric and adult congenital heart disease (ACHD) patients. To evaluate baseline CIED remote monitoring (RM) data among pediatric and ACHD centers prior to implementation of a Pediatric and Congenital Electrophysiology Society (PACES)-sponsored quality improvement (QI) project. This is a cross-sectional study of baseline CIED RM. Centers self-reported baseline data: individual center RM compliance was defined as high if there was > 80% achievement and low if < 50%. A total of 22 pediatric centers in the USA and Australia submitted baseline data. Non-physicians were responsible for management of the RM program in most centers: registered nurse (36%), advanced practice provider (27%), combination (23%), and third party (9%). Fifteen centers (68%) reported that > 80% of their CIED patients are enrolled in RM and only two centers reported < 50% participation. 36% reported high compliance of device transmission within 14 days of implant and 77% of centers reported high compliance of CIED patients enrolled in RM. The number of centers achieving high compliance differed by device type: 36% for pacemakers, 50% for ICDs, and 55% for Implantable Cardiac Monitors (ICM). All centers reported at least 50% adherence to recommended follow-up for PM and ICD, with 23% low compliance rate for ICMs. Based on this cross-sectional survey of pediatric and ACHD centers, compliance with CIED RM is sub-optimal. The PACES-sponsored QI initiative will provide resources and support to participating centers and repeat data will be evaluated after PDSA cycles.
摘要：
心脏可植入电子设备（CIED）远程传输是儿科和成人先天性心脏病（ACHD）患者纵向随访的组成部分。在实施儿科和先天性电生理学会（PACES）赞助的质量改进（QI）项目之前，评估儿科和ACHD中心的baselineCIED远程监测（RM）数据。这是基线EDRM的横断面研究。中心自我报告的基线数据：如果成就>80%，则将单个中心RM依从性定义为高，如果<50%，则定义为低。美国和澳大利亚共有22个儿科中心提交了基线数据。在大多数中心，非医师负责管理RM计划：注册护士（36％），高级实践提供商(27%)，合并（23%），和第三方（9%）。15个中心（68％）报告>80％的CIED患者纳入RM，只有两个中心报告<50％参与。36%的患者在植入后14天内报告了器械传播的高依从性，77%的中心报告了在RM中登记的CIED患者的高依从性。实现高依从性的中心数量因设备类型而异：起搏器为36％，ICD的50%,和55％的植入式心脏监护仪（ICM）。所有中心报告至少50%的患者对PM和ICD的建议随访依从性。ICM的依从率低23%。根据对儿科和ACHD中心的横断面调查，符合CIEDRM是次优的。PACES赞助的QI计划将为参与中心提供资源和支持，重复数据将在PDSA周期后进行评估。
