Remote vs. In Clinic PM Evaluation

Is remote monitoring a better option than peridic monitoring in Dr.'s office?

I have a Medtroncs PM, implanted at Johns Hopkins in Baltimore in July 2022. They sent me home with a remote monitor and a quarterly PM evaluation report posts to my medical record. Unfortunately, my local cardiologist (the one that referred be for a TAVR and pacemaker) is not in the Hopkins network and has no interest in reading/discussing the Hopkins  quarterly evaluation reports; instead, his admin recommends I enroll in their local 'pacemaker clinic' for a once or twice/year interogation. I'd have to disenroll from Johns Hopkins monitoring.

I like my local cardiologist, but believe remote monitoring provides more useful data. I'm willing to make the commute to Baltimore to find a Hopkins cardiologist that will discuss the PM evaluations. Does remote monitoring provide an advantage that would make switching cardiologists worthwhile?

5 Comments

Hello🙂

by Lavender - 2024-07-14 09:34:16

You have already been going along this way for two years. Is there a reason to change?

I have both home monitoring as well as inperson clinic at my cardiologist office. The monitor watches over nightly and does an every six month transmission to my cardiologist office. That alternates with my every six month inperson clinic visits. So I am checked more thoroughly every three months-in addition to the nightly checks. 
 

Do you see your cardiologist in person at all for pacemaker checks?

Is anyone reading your monitor reports?

I think it would be helpful having everything on the same page. You seem pleased with Johns Hopkins and willing to travel, so maybe condense it all there. 
 

I have an issue with one lead (wire) so I'm glad to have nightly monitoring. 

switch it

by Tracey_E - 2024-07-14 13:00:10

They should be able to go through Medtronic and have the reports sent directly to your doctor rather than through Hopkins. I did this when I switched doctors. 

I don't think it's either/or

by crustyg - 2024-07-14 13:02:33

Like many others I have a device under my bed.  Every night it contacts my PM for any Events that are set to act as Alarms.  If nothing then it's all OK.

*If* there's something to report, my device gathers the data, and sends it all to my EP-team, and I may receive a telephone call.

I'm not sure that I see how quarterly in-person EP-clinic sessions could provide that level of oversight.  For me, getting into the clinic is really easy, it's only a few miles, and the EP-team are great.  But the time cost to them is significant (and me too), so knowing that my evolving condition is being monitored every day is far better for me than waiting another 3months.  For folk who are hours away from their EP-team, remote monitoring seems essential.

Question: is your local cardiologist a 'plumbing' cardiologist (you had a TAVR)?  Sounds as though the JH team are Electrophysiology experts.  It's not unrealistic to have a cardiologist of each type.  There *are* a few who do both very well, but that's a minority skill.

Remote monitoring

by piglet22 - 2024-07-15 06:47:48

I miss the face to face clinics and I suspect the EP staff do too.

I see it a purely cost cutting exercise and was given odd reasons like it was challenging for staff and patients.

What is challenging about a 20 minute appointment is beyond me.

There recently cut the annual "virtual device clinic" to no patient contact at all unless something was wrong. Not even a 10 minute phone call.

My old Medtronic MyCareLink monitor makes no contact with the data hub unless I initiate it, and having had one battery fail on me, I'm pretty wary with a replacement looming.

I've also had pacemaker induced blackouts so hoping that the new device has better communication.

I'm not persuaded that home monitoring is a good substitute for F2F with old devices, but might feel better about it if I get a better device soon.

remote monitoring

by new to pace.... - 2024-07-15 14:35:19

Am checked nightly and the quartely remote is so they can get paid.  If the heart speciaslist office remembers to charge .  Go into the pacemaker clinic once a year to be checked.  If the nightly one sees something the cardilogist is notified and then notify me. Been doing this way since Aug 2019

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