An interventional study of Routine Management and 5G Cloud Follow-up in Sick Sinus Syndrome, Atrioventricular Block, Second and Third Degree and Heart Failure, sponsored by The Third People's Hospital of Chengdu. Recruiting at 2 sites in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-11-21.
Sponsored by The Third People's Hospital of Chengdu · Not applicable, Interventional, and Health services research
Objective: This clinical study employs a prospective, paired, self-controlled, non-inferiority, multicenter research design to assess the safety and efficacy of utilizing 5G cloud follow-up for CIED in parameters monitoring and remote programming post-implantation.
Participants will:
undergo regular clinic follow-up visits in accordance with the guidelines undergo routine in-office follow-up and 5G cloud follow-up during each regular clinic visit
Background: Cardiovascular implantable electronic devices (CIED) include pacemakers, implantable cardioverter defibrillators (ICD), cardiac resynchronization therapy (CRT) pacemakers and defibrillators, implantable cardiac event recorders (ICM), and implantable cardiovascular monitors. They are mainly used for the diagnosis, monitoring, and treatment of bradycardia, tachycardia, and heart failure (HF). There are currently two main methods of follow-up: routine in-office follow-up and remote monitoring (RM). Routine in-office follow-up is the most commonly used method in China, whereby professional doctors and/or manufacturer engineers conduct follow-ups under the guidance of physicians. Remote monitoring (RM) allows patients to be remotely monitored at home or elsewhere when a communication network is available, receiving periodic alerts related to the patient. Remote monitoring (RM) can provide timely and accurate CIED data and information, promptly alerting clinical doctors to any issues. However, a drawback is that patients still need to visit the hospital for device parameter adjustments, so it only partially fulfills the functions of routine in-office follow-up. Of note, in the past three years, some domestic clinical centers in China have begun exploring the application of 5G cloud follow-up remote programming (5G Cloud Follow Up) in various patient follow-up scenarios. With the comprehensive deployment of 5G networks in China, central hospitals with specialized device programmers can establish one-to-one or one-to-many regional collaborative cloud follow-up systems with primary hospitals lacking follow-up technician through 5G networks. CIED patients only need to visit nearby primary hospitals to complete regular device follow-ups. Currently, excellent research results have been obtained in the quality control of the CIED follow-ups of a single provincial medical consortium system mainly consisting of major implantation centers. However, there is still a lack of verification results for 5G cloud follow-up remote programming in a medical consortium (MC) model covering various administrative regions in China and different levels of primary hospitals. This study will compare the safety and effectiveness of using 5G cloud follow-up remote programming in different administrative regions and levels of primary hospitals in China with routine in-office follow-ups.
Objective:
This clinical study employs a prospective, paired, self-controlled, non-inferiority, multicenter research design to assess the safety and efficacy of utilizing 5G cloud follow-up for CIED in parameters monitoring and remote programming post-implantation.
Participants will:
undergo regular clinic follow-up visits in accordance with the guidelines undergo routine in-office follow-up and 5G cloud follow-up during each regular clinic visit
Inclusion Criteria:
Exclusion Criteria:
If meeting any of the following, the individual cannot be included:
CIED patients undergo both 5G cloud follow-up and routine in-office follow-up during each visit.
Other: Routine Management · Device: 5G Cloud Follow-up
Conducting routine in-office follow-up for CIED paitents
This study employed a 5G-cloud follow-up platform, a research tool that allows a device specialist to test, and program CIEDs in real-time from a remote location via an internet connection or mobile wireless network. Consistent with of the 5G remote support terminal externally connected to the programmer, a PAD was installed with a 5G-cloud follow-up app. The onsite medical staff began the cloud follow-up session by contacting the remote device specialist via video call. The connection to the CIED was made by the medical staff through the use of a standard programmer. He was in charge of turning on the programmer and applying the programmer wand to the patient's device. After an initial introduction, communication was established and continued via the wand connection. The remote device specialist logged into the 5G-cloud follow-up app with two-step verification. The remote device specialist then had complete control of the programmer to check and reprogram the device as needed.
Parameter Measurement Consistency
Subjects underwent in-office follow-up and 5G cloud follow-up to test battery parameters (battery voltage, battery current, and magnet frequency) and lead parameters (amplitude, pacing threshold, and impedance) in the immediate postoperative period, prior to discharge from the hospital, and within 1 month of implantation, within 1 to 3 months of implantation, at 6 months of implantation, and at 12 months of implantation, respectively. The consistency of each parameter measured at both follow-up modalities was analyzed at the end of the trial by regression fitting equations and Pearson correlation coefficients.
Time frame: through study completion, an average of 1 year
Parameter Measurement Time
During each follow-up, all subjects undergo separate routine in-office follow-ups and 5G cloud follow-ups. The time taken from the beginning of device interrogation to the completion of parameter testing is recorded for each follow-up.
Time frame: through study completion, an average of 1 year
Program Completion Rate
Evaluation Approach: Participants undergo both in-person clinic follow-up and 5G cloud follow-up during each appointment. Researchers will evaluate and programe the device in accordance with the current guidelines. The assessment of program completion will be conducted through the Program Control Completion Assessment Form. Completion Criteria: If all parameter reprogramming statuses are indicated as "Yes", the program control session will be deemed as complete. In cases where any program control completion status is marked as "No", the session's program control will be considered incomplete. Program Completion Rate is calculated as follows: the number of successful programming / the total number of programming
Time frame: through study completion, an average of 1 year
adverse events
Subjects are observed and recorded at any time during the study process after enrollment. Summarize the occurrence of adverse events and calculate the rate of adverse events. Participants will be continuously monitored and documented during each follow-up session. The adverse event is defined according to the "Guidelines for Reporting Adverse Events and Device Defects" in the present study. Investigators will record and summarize the occurrence of adverse events and determine the rate of adverse event incidence. The rate of adverse event is calculated as the number of participants occurring adverse event/ the total number of the participants.
Time frame: through study completion, an average of 1 year
Plan to share: Undecided — The datasets in the study might be available upon reasonable request.
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The Third People's Hospital of Chengdu