Carelink network

The present research was designed as an observational, two-stage, cross-sectional, multicenter study to develop a specific instrument for the measurement of patient satisfaction with RM of CIED. Patients with implanted pacemakers (PM), ICD, and CRT devices who had been using CareLink® Network for at least 2 months before recruitment were included. The study was conducted under actual treatment conditions for their disorder in clinical practice.
The Medtronic CareLink® Network is the Internet-based remote monitoring service for patients with Medtronic implanted cardiac devices. It allows patients a convenient timely connection to their clinic using the person’s monitor/ smartphone/ tablet to collect and transmit device data. A hand-held smart reader is used to collect data from the implanted device. The smart reader communicates with the monitor and, through a software application, it transfers the data to the CareLink® Network. All the information is recorded and reviewed by the nurses through the online platform. In case there is a critical event, the patient is called by the medical staff to visit the physician (Figure 6 Additional file 3).
The study was performed following the Helsinki-Tokyo-Venice guidelines for human research.

The technology used in the study was the Medtronic CareLink^® Network, which is an internet-based RM service for patients with Medtronic implantable heart devices. The monitor gathered information from patients at home using a standard phone line and sent it to authorised hospitals [25 ]. Currently, PM communication with the transmitter is completely automatic in some models, without the intervention of the patient.

ICMs (Reveal LINQ; Medtronic, Minneapolis, MN, USA) were implanted under local anesthesia in the left parasternal position at 45 degrees relative to the sternum above the fourth intercostal space. Devices were programmed to detect AF using the company's unique AF detection algorithm. These algorithms recognize AF by assessing the irregularity of R-R peaks in 2 min intervals. The Medtronic CareLink Network was used to transmit device data remotely. The study physician received an alert if the device detected an AF episode. Detected AF episodes were adjudicated by the study physician. The ICM monitoring data up to June 2018 were used for current analysis.

Between January 2010 and December 2012, patients with a CIED were recommended to undergo remote monitoring at the discretion of the attending cardiologists. Since January 2013, all patients who underwent CIED-related procedures were routinely recommended for the implementation of remote monitoring. In the remote monitoring systems provided by three venders (Home Monitoring™, Biotronik; Latitude Patient Management system™, Boston Scientific, and Merlin.net™, Abbott) the records were automatically transmitted to our institution once a week via home transmitters. In the system from the fourth vendor (CareLink Network™, Medtronic, Inc.), data from the patients with a pacemaker were transmitted once a month, whereas data from patients with an implantable cardioverter defibrillator and cardiac resynchronization therapy were transmitted once a week. The data were reviewed by experienced clinical engineers and electrophysiologists once a week. When unscheduled transmissions were obtained, the data were quickly reviewed. Inquiry for patients was performed by physicians when the scheduled transmission was missed for a week.