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A Pilot Study of Implantable Cardiac Device Interrogation by Emergency Department Personnel

Neuenschwander, James F. MD*; Hiestand, Brian C. MD; Peacock, W. Frank MD; Billings, John M. MD§; Sondrup, Cole MD; Hummel, John D. MD; Abraham, William T. MD

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine: March 2014 - Volume 13 - Issue 1 - p 6–8
doi: 10.1097/HPC.0000000000000000
Original Articles

Background: Implanted devices (eg, pacemakers and defibrillators) provide valuable information and may be interrogated to obtain diagnostic information and to direct management. During admission to an emergency department (ED), significant time and cost are spent waiting for device manufacturer representatives or cardiologists to access the data. If ED personnel could safely interrogate implanted devices, more rapid disposition could occur, thus leading to potentially better outcomes at a reduced cost. This was a pilot study examining the feasibility of ED device interrogation.

Methods: This was a prospective convenience sample study of patients presenting to the ED with any chief complaint and who had an implantable device capable of being interrogated by a Medtronic reader. After obtaining informed consent, study patients underwent device interrogation by ED research personnel. After reviewing the device data, the physician documented their opinions of the value of data in aiding care. Patients were followed up at intervals ranging from 30 days out to 1 year to determine adverse events relating to interrogation.

Results: Forty-four patients underwent device interrogation. Their mean age was 56 ± 14.7 years (range, 28–83), 75% (33/44) were male and 75% (33/44) were hospitalized from the ED. The interrogations took less than 10 minutes 89% of the time. In 60% of the cases, ED physicians reported the data-assisted patient care. No adverse events were reported relating to the ED interrogations.

Conclusions: In this pilot study, we found that ED personnel can safely and quickly interrogate implantable devices to obtain potentially useful clinical data.

From the *Department of Emergency Medicine, Ohio State University Medical Center, Columbus, OH; Department of Emergency Medicine, Wake Forest University Health Sciences, Winston-Salem, NC; Department of Emergency Medicine, Baylor College of Medicine, Houston, TX; §Department of Radiology, Wake Forest University Health Sciences, Winston-Salem, NC; Department of Emergency Medicine, Sunrise Hospital, Las Vegas, NV; and Division of Cardiovascular Medicine, Ohio State University Medical Center, Columbus, OH.

An institutional grant was received by Medtronic Corporation.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.critpathcardio.com).

Reprints: James F. Neuenschwander, MD, 800 Forest Avenue, Zanesville, OH 43701. E-mail: jim.neuen@gmail.com.

© 2014 by Lippincott Williams & Wilkins