Biotronik (BIOTRONIK SE & Co. KG; Biotronik Worldwide) is a limited partnership multi-national cardiovascular biomedical research and technology company, headquartered in Berlin, Germany.The company offers equipment for diagnosis, treatment, and therapy support in the areas of cardiac rhythm management, electrophysiology, and vascular intervention. In the area of cardiac rhythm management, Biotronik Home Monitoring uses tele-monitoring technology to provide doctors with up-to-date information for implant patients.Biotronik employs more than 9,000 people worldwide in over 100 countries, with research and development activities in Europe, North America, and Singapore. It produces all critical components of its products in-house. One in every five employees at its Berlin headquarters works in research and development (R&D).
Introduction: Clinical guidelines codify aspects of ICD deactivation to avoid shocks at the end of patients’ lives. Therapy-restrictive programming also reduces unnecessary shocks regardless of patients’ clinical circumstances. Research Questions: To define rates of ICD deactivation, ICD shocks proximate to the dying process, and therapy-restrictive programming in real-world settings. Methods: This study analyzed data from Biotronik’s CERTITUDE registry, a real-world research database with 95,000 U.S. Biotronik CIEDs that utilize Home Monitoring. We included deceased individuals with a CRT-D or ICD implanted between 2016 and 2024 using vital status from the Medicare Master Beneficiary Summary File. Individuals who were not Medicare FFS beneficiaries or those with no transmissions in the last 90 days of life were excluded. The primary outcomes were ICD deactivation or receipt of ICD shock within the last 90d, 30d, or 3d of life, with percentages calculated relative to the number of patients with any transmissions in the given time period. We also characterized patients’ tachytherapy programming as therapy-restrictive (first therapy initiated at HR > 200 + > 30 intervals) or not. Results: A total of 334 patients met study criteria (mean age at implant 77 + 7.9 years, 23.5% women, 54.5% CRT). The range of days between implant and death was 8-2905 days, with 37 patients having less than 6 months between implant and death. Among 334 patients total with a transmission within 90d of death, 41 patients (12%) received an ICD shock in the last 90d of life, whereas 32/287 (11%) received a shock in the last 30d of life, and 17/172 (10%) received a shock in the last 3d of life, with similar numbers of patients having their ICDs deactivated for at least part of each specified period of observation ( Table ). None of the 334 patients met criteria for therapy-restrictive programming. Conclusions: ICD shocks in the final months of patients’ lives impact a substantial proportion of device recipients, a burden likely underestimated in this dataset given inclusion/exclusion criteria and technical limitations of observation via remote monitoring. Implementation of therapy-restrictive programming and ICD deactivation may offer additional modifiable targets to improve patients’ end-of-life circumstances.
BackgroundAs remote monitoring has become the standard of care for follow-up of cardiac implantable cardiac devices, extensions of remote monitoring can provide greater efficiency for the patient, caregiver, and industry representatives. To accomplish greater efficiency and flexibility of remote monitoring, and as an interim step toward "true" remote monitoring, LiveSupport was introduced as an innovative programmer and software solution that allows for remote programming of all current and most legacy BIOTRONIK devices.ObjectiveTo determine the utilization and efficacy of LiveSupport as an extension of remote monitoring and the level of satisfaction with this modality. Methods Analysis of the USA dataset of LiveSupport utilization from 04/01/2022 to 04/30/2025 was completed. In addition, satisfaction with LiveSupport was assessed with a total of 159 surveys of patients, remote caregivers, and industry representative.ResultsA total of 38,943 total LiveSupport sessions, from 2831 unique Renamic Neo Programmers, and 555 unique users were successfully completed. LiveSupport utilization increased substantially over time, peaking at 2,295 sessions per month. Survey results were consistent with high levels of satisfaction for patients, remote caregivers, and industry representatives. It was estimated that LiveSupport saved more than 60 min per patient in 78% of the sessions.ConclusionLiveSupport as an extension of remote monitoring is safe and effective with marked advantages for patients, remote caregivers, and industry representatives. This technical solution is an important step toward "true" remote monitoring of cardiac electronic implantable devices.
