TY  - JOUR
AU  - Hermans, Mathilde C
AU  - Van Mourik, Martijn S
AU  - Hermens, Hermie J
AU  - Baan Jr, Jan
AU  - Vis, Marije M
PY  - 2018
DA  - 2018/03/16
TI  - Remote Monitoring of Patients Undergoing Transcatheter Aortic Valve Replacement: A Framework for Postprocedural Telemonitoring
JO  - JMIR Cardio
SP  - e9
VL  - 2
IS  - 1
KW  - transcatheter aortic valve replacement
KW  - postoperative care
KW  - electrocardiography
KW  - telemonitoring
KW  - telemedicine
AB  - Background: The postprocedural trajectory of patients undergoing transcatheter aortic valve replacement (TAVR) involves in-hospital monitoring of potential cardiac rhythm or conduction disorders and other complications. Recent advances in telemonitoring technologies create opportunities to monitor electrocardiogram (ECG) and vital signs remotely, facilitating redesign of follow-up trajectories. Objective: This study aimed to outline a potential set-up of telemonitoring after TAVR. Methods: A multidisciplinary team systematically framed the envisioned telemonitoring scenario according to the intentions, People, Activities, Context, Technology (iPACT) and Functionality, Interaction, Content, Services (FICS) methods and identified corresponding technical requirements. Results: In this scenario, a wearable sensor system is used to continuously transmit ECG and contextual data to a central monitoring unit, allowing remote follow-up of ECG abnormalities and physical deteriorations. Telemonitoring is suggested as an alternative or supplement to current in-hospital monitoring after TAVR, enabling early hospital dismissal in eligible patients and accessible follow-up prolongation. Together, this approach aims to improve rehabilitation, enhance patient comfort, optimize hospital capacity usage, and reduce overall costs. Required technical components include continuous data acquisition, real-time data transfer, privacy-ensured storage, automatic event detection, and user-friendly interfaces. Conclusions: The suggested telemonitoring set-up involves a new approach to patient follow-up that could bring durable solutions for the growing scarcities in health care and for improving health care quality. To further explore the potential and feasibility of post-TAVR telemonitoring, we recommend evaluation of the overall impact on patient outcomes and of the safety, social, ethical, legal, organizational, and financial factors. 
SN  - 2561-1011
UR  - http://cardio.jmir.org/2018/1/e9/
UR  - https://doi.org/10.2196/cardio.9075
UR  - http://www.ncbi.nlm.nih.gov/pubmed/31758782
DO  - 10.2196/cardio.9075
ID  - info:doi/10.2196/cardio.9075
ER  -