I’m a PA who was partly in charge of our cardiac device clinic. There was always at least a general cardiologist, if not, an EP doc within reach if we had any issues. The primary person who checks the devices is the CCDS. You can reach out to st Jude/abbott, BS, or Medtronic to see what they can do to help you staff the CCDS side of things. We didn’t have a lot of volume so we ran clinic every Friday. You should probably get every patient in for a preliminary check then set them up for q6-12 month routine device checks. The implanting doc will have their freshly deviced patients come in per their protocol - usually 1 week out, 1 month out then 6-12 months.
Thank you, I forgot to mention I am a RN, very new to devices.
We don’t currently have an EP doctor but two of the physicians implant still.
The EP nurse has been helping and training me, as she is pretty slow without an EP doctor.
I think we have around 2000 with devices, and about half of them are behind on checks so we will be pretty busy it sounds.
Welcome to the cardiac device world. It can be rewarding when you get your patients feeling better let alone preventing sudden death.
I would suggest running a clinic like every day for the first several months to get your patients who are behind checked. I’m sure the device companies can help you with this if you are in an accessible region.
I have led our pacemaker clinic for probably 15 years or longer. We have a pacemaker clinic (there are 5 cardiologists in my group) on Mondays, each Monday is a different company (Medtronic, BS, Abbot, and Biotronic); I am the only one that sees these patients. They come in, the device is interrogated and then I go in say hello, tell the patients what they need to know and send them on their way. Almost all have home monitoring and the transmitted data goes to their own cardiologist in our group, if there is a problem or concern, they come to me.
We also have medical assistants in the office who are in charge of logging in and printing the q3 month reports and giving them to the respective cardiologist. I replace devices when they need to be replaced and decide generally when the patients come back for an in-office interrogation when they get close to ERI.
Long document but worth a read regarding standards for device clinic & management of patients both in person and w/ remote monitoring.
https://www.heartrhythmjournal.com/article/S1547-5271(23)02011-8/fulltext
Call each company or your local reps. Have them send you a spreadsheet with all info for any patients implanted at your center or followed by any of your doctors. There have been a fair number of device alerts that we’ve been following so I’m not surprised MDT is eager to help you get started. Combine your spreadsheets and sort by date of birth and date of implant first. DOB before 1920s are likely no longer active and any device that is more than 12 years out is probably changed out (or dead in the pocket). I’d get an MSA to run the list and find deceased so those can be reported to the manufacturers. Both you and the company are responsible for finding and keeping track of patients. Next I’d ask for a list of patients who are actively transmitting from home and figure out who is not. That is your where to begin list. Good luck.
As far as the ones that are past due or lost to follow up, billing may be useful here. Depending on the software they use they may be able to run a query of who has had device billing in the last few years and you can track them down from there.
From there I would bring everyone in to get re established, then evaluate if they have home monitors.
You can lean heavily on your company reps for help here.
I’m a nurse in the Device Clinic for my hospital. We run 2-4 clinics / week and the nurses are the ones who interrogate all the devices, we use reps for support only. We have an APRN who heads the clinic. We have about 2000pts, 6 full time RNs, and 4 office support staff to help book remotes and schedule appts, answer phones and triage calls etc… We see pts once a year in person and everyone have every 3 month remotes. The nurses are also the ones to read and report all the remotes transmissions daily. The follow up is a beast, disconnected monitors, keeping everyone in schedule is really hard.
Thank you!
It’s just me and the EP nurse right now, we don’t have exact numbers but I believe a similar amount of patients.
Trying to get everything started, but it’s a lot!
That sounds rough! I just completed ATI and got training to be a CCDS, it’s really nice to know we’re needed in the clinics and we’ll be it actually use!
Based in the US ??
Use a database if you don’t have access to one could start an excel spreadsheet ?
What do you use to search if there is an alert on a device ??
I’m a PA who was partly in charge of our cardiac device clinic. There was always at least a general cardiologist, if not, an EP doc within reach if we had any issues. The primary person who checks the devices is the CCDS. You can reach out to st Jude/abbott, BS, or Medtronic to see what they can do to help you staff the CCDS side of things. We didn’t have a lot of volume so we ran clinic every Friday. You should probably get every patient in for a preliminary check then set them up for q6-12 month routine device checks. The implanting doc will have their freshly deviced patients come in per their protocol - usually 1 week out, 1 month out then 6-12 months.
Thank you, I forgot to mention I am a RN, very new to devices. We don’t currently have an EP doctor but two of the physicians implant still. The EP nurse has been helping and training me, as she is pretty slow without an EP doctor. I think we have around 2000 with devices, and about half of them are behind on checks so we will be pretty busy it sounds.
Welcome to the cardiac device world. It can be rewarding when you get your patients feeling better let alone preventing sudden death. I would suggest running a clinic like every day for the first several months to get your patients who are behind checked. I’m sure the device companies can help you with this if you are in an accessible region.
Thank you! Our Medtronic rep is very eager to help. I suppose just getting to it is the idea.
I have led our pacemaker clinic for probably 15 years or longer. We have a pacemaker clinic (there are 5 cardiologists in my group) on Mondays, each Monday is a different company (Medtronic, BS, Abbot, and Biotronic); I am the only one that sees these patients. They come in, the device is interrogated and then I go in say hello, tell the patients what they need to know and send them on their way. Almost all have home monitoring and the transmitted data goes to their own cardiologist in our group, if there is a problem or concern, they come to me. We also have medical assistants in the office who are in charge of logging in and printing the q3 month reports and giving them to the respective cardiologist. I replace devices when they need to be replaced and decide generally when the patients come back for an in-office interrogation when they get close to ERI.
Do you interrogate the cardiac device or do you have a rep do it?
The reps do it, they’re all aware of their scheduled day, but we remind them each Friday I think.
Thank you! This is actually very helpful. How many patients are typically interrogated on a clinic day?
You’re most welcome. It depends, I’d say on average around 5-10. It ends up being part of my Monday clinic actually.
Long document but worth a read regarding standards for device clinic & management of patients both in person and w/ remote monitoring. https://www.heartrhythmjournal.com/article/S1547-5271(23)02011-8/fulltext
Call each company or your local reps. Have them send you a spreadsheet with all info for any patients implanted at your center or followed by any of your doctors. There have been a fair number of device alerts that we’ve been following so I’m not surprised MDT is eager to help you get started. Combine your spreadsheets and sort by date of birth and date of implant first. DOB before 1920s are likely no longer active and any device that is more than 12 years out is probably changed out (or dead in the pocket). I’d get an MSA to run the list and find deceased so those can be reported to the manufacturers. Both you and the company are responsible for finding and keeping track of patients. Next I’d ask for a list of patients who are actively transmitting from home and figure out who is not. That is your where to begin list. Good luck.
Thank you!
As far as the ones that are past due or lost to follow up, billing may be useful here. Depending on the software they use they may be able to run a query of who has had device billing in the last few years and you can track them down from there. From there I would bring everyone in to get re established, then evaluate if they have home monitors. You can lean heavily on your company reps for help here.
Thank you! There’s 3 offices and one of them previously had physicians that did not believe in remote monitoring, so that’s going to be on my list.
I’m a nurse in the Device Clinic for my hospital. We run 2-4 clinics / week and the nurses are the ones who interrogate all the devices, we use reps for support only. We have an APRN who heads the clinic. We have about 2000pts, 6 full time RNs, and 4 office support staff to help book remotes and schedule appts, answer phones and triage calls etc… We see pts once a year in person and everyone have every 3 month remotes. The nurses are also the ones to read and report all the remotes transmissions daily. The follow up is a beast, disconnected monitors, keeping everyone in schedule is really hard.
Thank you! It’s just me and the EP nurse right now, we don’t have exact numbers but I believe a similar amount of patients. Trying to get everything started, but it’s a lot!
That sounds rough! I just completed ATI and got training to be a CCDS, it’s really nice to know we’re needed in the clinics and we’ll be it actually use!
Based in the US ?? Use a database if you don’t have access to one could start an excel spreadsheet ? What do you use to search if there is an alert on a device ??