Cardiac Device Therapy

Boston Scientific is committed to improving the quality of life for cardiac patients through the use of device therapy and the LATITUDE® Patient Management system. The LATITUDE system is compatible with virtually all of Boston Scientific's implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy defibrillators (CRT-D).

What is a defibrillator (ICD device)? — An implantable cardioverter defibrillator (ICD) is a small device that treats abnormal heart rhythms called arrhythmias. Specifically, an ICD device treats fast arrhythmias in the heart's lower chambers (ventricles).

What is a heart failure device (CRT-D device)? — A heart failure device, also called a CRT-D device, treats certain types of heart failure. When the heart's lower chambers (ventricles) pump or contract in an uncoordinated way, it causes dyssynchrony. 'CRT' stands for 'cardiac resynchronization therapy.' It gets its name because the device helps resynchronize, or re-coordinate, the pumping of the ventricles. A CRT-D device contains a built-in ICD device.

Life-threatening Arrhythmia and Heart Failure

Life-threatening Arrhythmia

Arrhythmia is the result of a problem in the heart's electrical system. Normal electrical signals should follow a certain path through the heart, causing it to contract properly. However, when too many signals occur or the signals do not travel the proper pathways, the heart tries to compensate by beating faster causing an arrhythmia. Some arrhythmias are life-threatening and can put a person at risk of sudden cardiac arrest — and if it's not treated immediately with defibrillation, it can result in sudden cardiac death.

Sudden death due to cardiac arrest affects 460,000 people each year in the United States — more than AIDS, breast cancer and lung cancer combined¹

Patients with life-threatening arrhythmias who do not receive an ICD are at high risk of sudden cardiac death²

95% of people with an ICD will survive an episode of sudden cardiac arrest³

Heart Failure

Heart failure is a progressive condition in which the heart muscle is damaged by disease or injury. As a result of the damage, the heart is unable to pump properly, causing arrhythmia that can lead to sudden cardiac arrest.

Five million people with heart failure in the United States⁴

285,000 deaths from heart failure per year (50,000 as primary cause)⁵

After Implant

Device Checks and Follow-ups

Once a doctor has implanted an ICD, it is very important to follow the doctor's guidelines for device follow-up. These device follow-ups allow the doctor to check your device and your heart health. Also, heart conditions can change over time, and regular device follow-ups help make the doctor aware of changes and needs for adjustments.

At a typical in-office follow-up visit, the nurse or doctor will check the ICD’s settings, collect information stored in its memory and adjust the device’s programming if necessary. In addition, the doctor or nurse will use this time to check the energy in the ICD’s battery.

LATITUDE Patient Management system

The LATITUDE Patient Management system allows the doctor and clinic staff to collect data from the implanted device remotely. This allows the clinic to receive similar information to what they would collect from a typical in-office visit without the patient actually having to come in to the doctor's office. While the LATITUDE system does not eliminate the need for all in-office visits, it has the potential to reduce the number of regularly scheduled in-clinic follow-ups.

Wireless or Wanded

For patients who have a wireless (radio frequency or RF) device, LATITUDE Active Monitoring™ enables automatic device checks as frequently as daily. For all other devices, the patient uses a "wand" to collect data from their ICD or CRT-D devices, as prompted by the Communicator and as scheduled by the doctor. The collected data is then sent over the patient's regular phone line (the communicator plugs into a standard phone jack) to a secure website where it can be accessed by the doctor, clinic staff and primary cardiologist.

LATITUDE Heart Failure Management System

If prescribed by the doctor, the patient may also use the LATITUDE Heart Failure Management system to monitor their heart failure status. The LATITUDE Heart Failure Management system offers doctors objective data that can help guide treatment decisions. This data includes:

Implanted device diagnostics (e.g., arrhythmias, heart rate variability, activity log)

Wireless transmission of weight and blood pressure, optional

Actionable daily weight alerts, optional

Symptom self-report questions, optional

This information, also sent by the Communicator to the secure website, provides timely insights and allows the clinic to intervene earlier than the next scheduled in-office visit, if necessary.

¹MMWR Weekly February 15, 2002/51(06); 123-6: State-Specific Mortality from Sudden Cardiac Death --- United States, 1999.
²About sudden cardiac death from cardiac arrest; Heart Disease and Stroke Statistics—2003 Update, American Heart Association. 2002:3.
³Himmrich E, et al. Is ICD programming for double intraoperative defibrillation threshold energy safe and effective during long-time follow-up? Results of a prospective randomized multicenter study (Low-Energy ENDOTAK Trial - LEFT). Z Kardiol. 1999;88:103-12 [German language edition].
⁴American Heart Association. Heart Disease and Stroke Statistics—2004 update.
⁵American Heart Association. Heart Disease and Stroke Statistics—2004 update.