Aside from emergency situations, patients requiring pacemakers have a chance to chat with their doctors about what type of devices are available to them, how they work and the benefits of each. Trouble is, in those appointments, they might not ask everything they want to ask and will leave without all the answers they need. Being a well-informed patient is important.
YouAreUNLTD spoke to Amber Seiler, an arrhythmia services program coordinator and nurse practitioner, about what to ask healthcare providers about pacemakers and new technology now available to heart patients. She works in the device clinic of Cone Health, which monitors more than 5,000 patients, in Greensboro, North Carolina, and has firsthand knowledge to share with Canadians.
YouAreUNLTD: When meeting with a heart specialist to discuss pacemakers, what should patients do to make the most out of their appointments?
Amber Seiler: They should be asking their doctor about which device they are going to get and ask why it is right for them. Their provider should be able to answer that question without any hesitation. They’ll also want to know how their device will be monitored from home, what the plan is for long-term monitoring, and how often they will need to go into their doctor’s office.
I would also suggest patients write down their questions before their appointments, especially during COVID when they may not be able to have family members with them. Patients need to have that list of questions when they come in. We also encourage patients to call caregivers or family members and put them on speakerphone during their consultation – the more people hearing the information, the better. Everyone needs to be on the same page about what the surgery involves, recovery, healing, etc.
YAU: What impact has COVID had on heart patients?
AS: COVID has really highlighted the need for remote care. With our clinic, if a patient is doing remote monitoring and we are able to get their data through transmissions, we’re doing virtual visits. We encourage patients not to come into the office unless it’s necessary to decrease the risk of exposure.
YAU: What have you heard from patients about their experiences with an app-enabled device?
AS: Patients love it. Our clinic was one of the first to adopt this technology and offer it to patients. It has been a game-changer for many reasons. There’s no home monitor that has to sit at their bedside tables, which is a constant reminder for patients that they have a medical issue. If there’s an app on their phone, they don’t really think about it. It’s just part of their lives.
It also allows friends and family to be more involved with a patient’s care and to be able to have a line of sight to that transmission and knowing the data is being reviewed as it should be. It’s reassurance. They can pull up their app to see information on things like activity level and battery status for their device. Patients haven’t had access to that in the past with home-based monitors since they aren’t any feedback mechanisms with them.
They feel empowered in their care and have less anxiety when they’re able to pull up their app and know they’re connected. Those capabilities are something we’ve never been able to offer patients before, but ones they’ve been inquiring about for a long time.
YAU: What are the common myths you hear about this new technology?
AS: One common question from patients is, ‘Will anyone be able to hack into my device and change something?’ The answer is ‘no.’ The technology is incredibly safe. It’s encrypted to meet all safety and security standards. Another myth is that we’re watching their heartbeat all the time. Somebody is not sitting in front of a monitor, watching every heartbeat that goes across the screen. We do have alerts set up to notify us if anything’s wrong or worrisome.
YAU: With older patients, there may be a belief they won’t be comfortable with using an app. Can you speak to that?
AS: There is a common misconception that older patients are not able to handle this technology and use it adequately. We’ve proven that to be false time and time again. We had a 92-year-old patient who needed a pacemaker and thought we should give her just a regular monitor. I walked into her room and she asking whether it would okay to be using her iPad and her iPhone in the clinic, Clearly, she was very comfortable with the technology. She proved a point that older people are quite adept with technology. They have it and they are used to it. They’re already using FaceTime to talk to their grandkids and playing Candy Crush, etc. These patients will know how to use the app-enabled technology, too. It is incredibly simple. I think it’s important for clinics to not push our own misconceptions on the patients and allow them to take advantage of the technology available.
“The app-enabled technology has really allowed them to be more involved in their care and take more ownership of it. I think it’s really important.”
YAU: How do caregivers feel about it?
AS: I think patients and caregivers are equally excited about the opportunity to use technology that they’re familiar with and that they know works – opposed to adding more monitoring hardware to their bedside table. Patients and families, for the most part, have been incredibly open and receptive to being monitored with app-based monitoring.
YAU: What would tell patients who are interested in app-enabling devices?
AS: They should talk to their healthcare provider about why they’re interested in that technology and see if it’s a good fit for them. It’s essential for patients to understand long-term monitoring because they will be with this device for 10-plus years.
I think it’s crucial to let patients know that there are options for monitoring and that they do have a say in what kind of device they get for their care. Just being educated about app-based monitoring is really important.
Presented through a sponsorship from Medtronic Canada.