Page 138 - Simplicity is Key in CRT

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Figure 4
Pre-discharge checklist. Completing this check-up makes sure short-term complications have been ruled out and patient has been educated and will be followed to minimize the chance of mid- to long-term complications. CRT = cardiac resynchronization therapy.
CRT follow-up management
Follow-up management should ensure adequate patient recovery from surgery and provide visit timelines and pathways to assess therapy effectiveness and to optimize CRT. Moreover, follow-up should strive to provide structured HF care and minimize hospital resource utilization.
4-6 weeks follow-up
The first outpatient clinical visit, is scheduled 4-6 weeks after discharge. At this visit the pocket wound and pain, as well as patient general well-being are assessed, with specific attention to signs of device-related complications. A device check-up includes standard device tests, diaphragm stimulation test, measurement of percentage of biventricular pacing, checking for the presence of arrhythmias and evaluation of the device HF diagnostics (patient activity, thoracic impedance measurements, heart rate variability, etc.). Also, enrolment in remote patient m onitoring is checked. If there are no complications and no signs of suboptimal CRT are present, the patient will continue with (already planned) regular follow-up schedule.
3 months (remote) follow-up
At three months a remote device transmission and remote clinical response evaluation is performed. This remote device transmission is evaluated for device function, percentage of biventricular pacing, presence of arrhythmias, and HF diagnostics.