Clinician use of data elements from cardiovascular implantable electronic devices in clinical practice

Carly Daley; Amanda Coupe; Tina Allmandinger; Jonathan Shirazi; Shauna Wagner; Michelle Drouin; Ryan Ahmed; Tammy Toscos; Michael Mirro

doi:10.1016/j.cvdhj.2022.10.007

Clinician use of data elements from cardiovascular implantable electronic devices in clinical practice

Cardiovasc Digit Health J. 2023 Jan 20;4(1):29-38. doi: 10.1016/j.cvdhj.2022.10.007. eCollection 2023 Feb.

Authors

Carly Daley¹, Amanda Coupe¹, Tina Allmandinger², Jonathan Shirazi², Shauna Wagner¹, Michelle Drouin¹, Ryan Ahmed¹, Tammy Toscos^{1

3}, Michael Mirro^{1

2

3

4}

Affiliations

¹ Parkview Mirro Center for Research and Innovation, Parkview Health, Fort Wayne, Indiana.
² Parkview Physicians Group-Cardiology, Parkview Health, Fort Wayne, Indiana.
³ Department of BioHealth Informatics, IUPUI School of Informatics and Computing, Indianapolis, Indianapolis.
⁴ Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.

Abstract

Background: Cardiovascular implantable electronic devices (CIEDs) capture an abundance of data for clinicians to review and integrate into the clinical decision-making process. The multitude of data from different device types and vendors presents challenges for viewing and using the data in clinical practice. Efforts are needed to improve CIED reports by focusing on key data elements used by clinicians.

Objective: The purpose of this study was to uncover the extent to which clinicians use the specific types of data elements from CIED reports in clinical practice and explore clinicians' perceptions of CIED reports.

Methods: A brief, web-based, cross-sectional survey study was deployed using snowball sampling from March 2020 through September 2020 to clinicians who are involved in the care of patients with CIEDs.

Results: Among 317 clinicians, the majority specialized in electrophysiology (EP) (80.1%), were from North America (88.6%), and were white (82.2%). Over half (55.3%) were physicians. Arrhythmia episodes and ventricular therapies rated the highest among 15 categories of data presented, and nocturnal or resting heart rate and heart rate variability were rated the lowest. As anticipated, clinicians specializing in EP reported using the data significantly more than other specialties across nearly all categories. A subset of respondents offered general comments describing preferences and challenges related to reviewing reports.

Conclusion: CIED reports contain an abundance of information that is important to clinicians; however, some data are used more frequently than others, and reports could be streamlined for users to improve access to key information and facilitate more efficient clinical decision making.

Keywords: Cardiovascular implantable electronic device; Clinical decision making; Digital health data; Remote monitoring; Survey methods.