LATITUDE Active Monitoring™ alerts clinic to new onset and subsequent recurrences of atrial flutter

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Patient background:

Implanting Physician: Raul Weiss, M.D., F.A.C.C., electrophysiologist

Allied Health Professional: Marc Dutro, R.N., B.S., device clinic supervisor

History: The patient experienced non-sustained ventricular tachycardia on a routine Holter monitor and subsequently had a CRT-D device implanted. The patient was enrolled in the LATITUDE Patient Management system post-implant.

Incorporating LATITUDE Active Monitoring into this patient's care: LATITUDE Active Monitoring reduces the need for long-distance travel to the office for routine evaluations. Dutro, a clinic AHP, said, "Remote monitoring benefits our clinic by allowing us to closely follow this device patient."

Situation: A few months after implant it was noted via a weekly alert notification that the patient had a new onset of atrial flutter.

Action: The patient was brought into the office for evaluation and admitted to the hospital for drug therapy with warfarin and dofetilide and for cardioversion. After two days, a transesophageal echocardiogram was performed to rule out intracardiac embolus. The echocardiogram was followed by a successful transthoracic cardioversion. The patient was then discharged home with the resumption of home monitoring using the LATITUDE Patient Management system.

Response: Two weeks later the patient called with symptoms of fatigue and palpitations. He was instructed to do a patient-initiated interrogation with his Communicator, which revealed recurrent atrial flutter. The patient was re-admitted for an atrial flutter ablation. Since the ablation there have been no new episodes of atrial arrhythmias. Dr. Weiss said, "With LATITUDE, patient care can progress more rapidly. We no longer have to wait for the three-month check to evaluate the effectiveness of treatment."

LATITUDE Heart Failure Management provides timely insight into your heart failure patients' status.

Promotes compliance to enable earlier interventions and is aligned with the 2005 ACC/AHA Heart Failure Guidelines.

Patients with LV dysfunction or heart failure typically present in 1 of 3 ways¹:

1. Decreased exercise tolerance: GUIDANT INSIGHT™ report provides an Activity Log, which correlates clinical history with physical activity.

2. Fluid retention: GUIDANT INSIGHT report provides daily weight (actionable alert notification), because increases in body weight commonly precede major clinical episodes².

3. Symptoms of cardiac or non-cardiac disorder: GUIDANT INSIGHT report provides a Patient Symptom Report which helps assess a patient's activities of daily living³.

Guidant has the complete solution for your patients on OPT who have:

¹ACC/AHA Guidelines 2005, page 10, section 3.1.1
²ACC/AHA Guidelines 2005, page 22, section 4.3.1.1
³ACC/AHA Guidelines 2005, pages 13-14, section 3.2.1
⁴Class I Indications for Stage C heart failure patients, ibid.

Individual symptoms, situations, and circumstances may vary. Patients should consult a physician or qualified health provider regarding their medical condition and appropriate medical treatment. The information provided is not intended to be used for medical diagnosis or treatment or as a substitute for professional medical advice. This information is to be used in conjunction with other resource material, which may include the applicable patient handbook, Boston Scientific device physician's manual and any implant accessories instructions for use.