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Current State of Cardiac Implantable Electronic Device Remote Monitoring in Pediatrics and Congenital Heart Disease: A PACES-Sponsored Quality Improvement Initiative

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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.

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Authors and Affiliations

  1. Division of Cardiology, Department of Pediatrics, Masonic Children’s Hospital, University of Minnesota, 2450 Riverside Ave, AO-405, Minneapolis, MN, 55454, USA

    Bradley C. Clark

  2. Division of Cardiology, Nicklaus Children’s Hospital, Miami, FL, USA

    Melissa Olen

  3. Division of Pediatric Cardiology, University of Michigan, Ann Arbor, MI, USA

    Brynn Dechert & Martin LaPage

  4. Division of Cardiology, Children’s Hospital of Colorado, Aurora, CO, USA

    Caitlin Brateng

  5. Division of Cardiology, Children’s National Medical Center, Washington, DC, USA

    Beth Jarosz

  6. Division of Cardiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Karen Smoots

  7. Division of Cardiology, Texas Children’s Hospital, Houston, TX, USA

    Patrick Connell

  8. Division of Cardiology, Nemours Children’s Hospital, Orlando, FL, USA

    Svjetlana Tisma Dupanovic

  9. Division of Cardiology, Dell Children’s Medical Center, Austin, TX, USA

    Arnold Fenrich

  10. Division of Cardiology, Children’s Hospital of Los Angeles, Los Angeles, CA, USA

    Allison C. Hill

  11. Division of Cardiology, Boston Children’s Hospital, Boston, MA, USA

    Douglas Mah

  12. Division of Cardiology, Children’s Hospital of Orange County, Orange, CA, USA

    Anthony McCanta

  13. Division of Cardiology, Children’s Mercy, Kansas City, MO, USA

    Lindsey Malloy-Walton

  14. Royal Children’s Hospital, MCRI and University of Melbourne, Melbourne, AU, USA

    Andreas Pflaumer

  15. Division of Pediatric Cardiology, Vanderbilt University Medical Center, Nashville, TN, USA

    Andrew Radbill & Aarti Dalal

  16. Division of Pediatric Cardiology, University of California-San Francisco, San Francisco, CA, USA

    Ronn Tanel

  17. Division of Cardiology, Children’s Healthcare of Atlanta, Atlanta, GA, USA

    Robert Whitehill

Authors
  1. Bradley C. Clark
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  2. Melissa Olen
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  3. Brynn Dechert
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  4. Caitlin Brateng
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  5. Beth Jarosz
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  6. Karen Smoots
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  7. Patrick Connell
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  8. Svjetlana Tisma Dupanovic
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  9. Arnold Fenrich
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  10. Allison C. Hill
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  11. Martin LaPage
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  12. Douglas Mah
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  13. Anthony McCanta
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  14. Lindsey Malloy-Walton
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  15. Andreas Pflaumer
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  16. Andrew Radbill
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  17. Ronn Tanel
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  18. Robert Whitehill
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  19. Aarti Dalal
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Consortia

the Pediatric and Congenital Electrophysiology Society (PACES)

Contributions

This survey is based on a QI project that was created by BC and AD with the support and guidance of RT and DM. All authors participated in the creation of resources for the QI project and submitted baseline data for this project. All authors participated in review of the manuscript.

Corresponding author

Correspondence to Bradley C. Clark.

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The authors declare no competing interests.

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Clark, B.C., Olen, M., Dechert, B. et al. Current State of Cardiac Implantable Electronic Device Remote Monitoring in Pediatrics and Congenital Heart Disease: A PACES-Sponsored Quality Improvement Initiative. Pediatr Cardiol 45, 114–120 (2024). https://doi.org/10.1007/s00246-023-03348-x

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