Stratification and management of cardiovascular risk in cancer patients. A consensus document of the SEC, FEC, SEOM, SEOR, SEHH, SEMG, AEEMT, AEEC, and AECC.

Both cancer treatment and survival have significantly improved, but these advances have highlighted the deleterious effects of vascular complications associated with anticancer therapy. This consensus document aims to provide a coordinated, multidisciplinary and practical approach to the stratification, monitoring and treatment of cardiovascular risk in cancer patients. The document is promoted by the Working Group on Cardio Oncology of the Spanish Society of Cardiology (SEC) and was drafted in collaboration with experts from distinct areas of expertise of the SEC and the Spanish Society of Hematology and Hemotherapy (SEHH), the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Radiation Oncology (SEOR), the Spanish Society of General and Family Physicians (SEMG), the Spanish Association of Specialists in Occupational Medicine (AEEMT), the Spanish Association of Cardiovascular Nursing (AEEC), the Spanish Heart Foundation (FEC), and the Spanish Cancer Association (AECC).

Efectividad y seguridad de la monitorización a distancia de los pacientes portadores de Holter insertable / Effectiveness and safety of remote monitoring of patients with an implantable loop recorder

Introducción y objetivos. El Holter insertable es una herramienta de probada eficacia en el estudio de pacientes con síncope y palpitaciones. La monitorización a distancia de los pacientes portadores de marcapasos y desfibriladores automáticos implantables se ha demostrado efectiva y segura. El objetivo de este estudio es analizar la efectividad y la seguridad de la monitorización a distancia de los pacientes portadores de Holter insertable. Métodos. Estudio retrospectivo observacional en el que se analizó a 109 pacientes portadores de Holter insertable y se comparó a dos grupos poblacionales: uno con seguimiento convencional con visitas presenciales trimestrales (41 pacientes) y otro con monitorización a distancia con transmisiones transtelefónicas mensuales y visitas anuales (68 pacientes). El seguimiento medio fue 64 (0,57-164,57) semanas. Se analizó el diagnóstico de un evento significativo, definido como aquel que llevó a una actitud terapéutica y justificó los síntomas que motivaron el implante, así como el tiempo medio desde el implante al diagnóstico y el tratamiento específico. Resultados. Se diagnosticó un evento significativo en el 82,6% de los casos; el 54,4% de ellos con registro electrocardiográfico normal; el 26,7%, asistolia; el 15,6%, taquicardia y el 3,3%, bradicardia. El tiempo medio desde el implante al diagnóstico fue 260 (5-947) días en seguimiento convencional, frente a 56 (0-650) días en los pacientes con monitorización a distancia (p < 0,01), lo que llevó a un tratamiento dirigido en este grupo un promedio de 187 días antes sin complicaciones secundarias. Conclusiones. La monitorización a distancia de los pacientes con Holter insertable permite acortar significativamente el tiempo hasta el diagnóstico y el tratamiento dirigido sin minar la seguridad del paciente (AU)

Introduction and objectives. Implantable loop recorders have proven efficacy in the study of patients with syncope and palpitations. Remote monitoring of patients with pacemakers and implantable cardioverter-defibrillators has been shown to be safe and effective. The purpose of this study was to analyze the safety and effectiveness of remote monitoring in patients with an implantable loop recorder. Methods. Retrospective observational study in which 109 patients with an implantable loop recorder were analyzed and 2 population groups were compared: 1 receiving conventional follow-up consisting of 3-monthly office visits (41 patients) and 1 with remote monitoring via monthly telephone transmissions and yearly visits (68 patients). The mean follow-up was 64 weeks (range, 0.57-164.57 weeks). The study analyzed diagnosis of a significant event, defined as any event that led to a therapeutic approach and explained the symptoms leading to the implant, as well as the mean time from implant to diagnosis and the specific treatment. Results. A significant event was diagnosed in 82.6% of patients; of these, 54.4% had a normal electrocardiogram; 26.7%, asystole; 15.6%, tachycardia, and 3.3%, bradycardia. The mean time from implant to diagnosis was 260 days (range, 5-947 days) in conventional follow-up, compared with 56 days (range, 0-650 days) in patients with remote monitoring (P<.01), which led to targeted treatment in this group 187 days earlier, on average, with no secondary complications. Conclusions. Remote monitoring of patients with an implantable loop recorder can significantly shorten the time to diagnosis and targeted treatment, without adversely affecting patient safety (AU)

Effectiveness and safety of remote monitoring of patients with an implantable loop recorder.

INTRODUCTION AND OBJECTIVES: Implantable loop recorders have proven efficacy in the study of patients with syncope and palpitations. Remote monitoring of patients with pacemakers and implantable cardioverter-defibrillators has been shown to be safe and effective. The purpose of this study was to analyze the safety and effectiveness of remote monitoring in patients with an implantable loop recorder. METHODS: Retrospective observational study in which 109 patients with an implantable loop recorder were analyzed and 2 population groups were compared: 1 receiving conventional follow-up consisting of 3-monthly office visits (41 patients) and 1 with remote monitoring via monthly telephone transmissions and yearly visits (68 patients). The mean follow-up was 64 weeks (range, 0.57-164.57 weeks). The study analyzed diagnosis of a significant event, defined as any event that led to a therapeutic approach and explained the symptoms leading to the implant, as well as the mean time from implant to diagnosis and the specific treatment. RESULTS: A significant event was diagnosed in 82.6% of patients; of these, 54.4% had a normal electrocardiogram; 26.7%, asystole; 15.6%, tachycardia, and 3.3%, bradycardia. The mean time from implant to diagnosis was 260 days (range, 5-947 days) in conventional follow-up, compared with 56 days (range, 0-650 days) in patients with remote monitoring (P<.01), which led to targeted treatment in this group 187 days earlier, on average, with no secondary complications. CONCLUSIONS: Remote monitoring of patients with an implantable loop recorder can significantly shorten the time to diagnosis and targeted treatment, without adversely affecting patient safety.