THORN Registry Shows Value of Quick Patient Data Transmission with BIOTRONIK Home Monitoring
Investigators Find Correlation Between Medical Reaction Time and the Risk of Recurring Inappropriate Diagnoses in ICD and CRT-D Patients
The observational THORN registry1 highlights the importance of rapid corrective action by medical staff in cases of inappropriate diagnosis and therapy using implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-D). The registry aimed to chart the rate of inappropriate ventricular arrhythmia diagnoses and therapies in patients followed through remote monitoring, as well as the impact of medical reaction time on future inadequate ventricular arrhythmia diagnosis. This research is important for designing the most efficient workflow procedures in clinics.
The THORN population included 1,882 patients implanted with ICDs for primary and secondary prevention in 110 centers in France. Patients were implanted with single-chamber ICDs (45%), dual-chamber ICDs (27%) and CRT-Ds (28%). They were followed-up using the BIOTRONIK Home Monitoring® system. Inappropriate ventricular arrhythmia diagnosis occurred in 9% of patients during 14-month follow-up. However, the rate of inappropriate shocks remained low (3%), most probably due to early corrective actions made possible by remote monitoring2.
The median time from inappropriate ventricular diagnosis by the ICDs to event confirmation using the remote monitoring platform was only one day. Nevertheless, the median time to next patient contact was eight days long. “Importantly, we found a correlation between the duration of the time to next patient contact and the risk of recurrence of inappropriate diagnoses before the corrective action occurred,” commented principal investigator Dr. Tilman Perrin, Centre Hospitalier Universitaire La Timone, Marseille, France. “Our data indicates that at least one additional day with inappropriate diagnosis occurred in 30% of medical reaction periods, with an inappropriate therapy in more than half of those recurrences.”
The authors encourage physicians to reduce delays to the corrective action after inadequate ventricular arrhythmia diagnoses, in order to prevent recurrences and potentially inadequate therapies. Implanting centers should thus define an efficient workflow for the initiation of remote monitoring, including clarification of roles concerning the management of the daily incoming data.
“The recent THORN study results point out that quick patient data transmission and the immediate reaction on quickly detected events are crucial for ICD and CRT-D patients,” stated Luc Cheminot, Country Manager at BIOTRONIK FRANCE. “This is just one of the advantages of our Home Monitoring. Our unique remote monitoring system shows how we at BIOTRONIK strive for innovative digital health solutions that help save and improve patients’ lives.”
The THORN trial was recently published in EP Europace. Previous studies on remote monitoring have also proven that BIOTRONIK Home Monitoring can reduce the rate of patients with inappropriate shocks3 and even all-cause mortality4.
1. Perrin T et al. Europace. 2019, 21(4).
2. Guédon-Moreau L et al. Eur Heart J. 2013, 34(8).
3. Guédon-Moreau L et al. J Cardiovasc Electrophysiol. 2014, 25(7).
4. Hindricks G et al. Lancet. 2014, 384(9943).
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