CASE STUDY: THE CLINICAL BENEFIT OF MOBILE CARDIAC OUTPATIENT TELEMETRY. June 22, 2009

Transcription

1 CASE STUDY: THE CLINICAL BENEFIT OF MOBILE CARDIAC OUTPATIENT TELEMETRY June 22, 2009 Sanjeev Wasson, MD, FACC, Medical Director, Department of Electrophysiology Skagit Valley Medical Center and Skagit Valley Hospital Mount Vernon, WA Anna McNamara, RN Senior Vice President of Clinical Operations CardioNet, Inc. 1 CardioNet, Inc. 2009

2 Mobile Cardiac Outpatient Telemetry 2 CardioNet, Inc. 2009

3 CardioNet Mobile Cardiac Outpatient Telemetry TM (MCOT TM ) SMART SENSOR WIRELESS MONITOR MONITORING CENTER PHYSICIAN / CUSTOMER Heartbeat by Heartbeat Surveillance Proprietary Algorithm 2 ECG Channels 21 Day Storage Automated Event Detection Symptom/Activity Touch Screen Asymptomatic Events Cellular Transmission 24/7/365 ECG Review Proprietary Software Urgent Notifications Fetch ECG Daily, Urgent, R equested and End of Service Summary Reports Web Access & Fax Reports Physician ECG Review via Web 3 CardioNet, Inc. 2009

4 Clinical Evidence (Publications/Abstracts) Completed CardioNet MCOT Ongoing Research Arrhythmia Diagnosis 5 1 AF Ablation 14 4 AF Management 3 Pediatrics 2 Cryptogenic Stroke 1 1 Hospital ER 1 Sleep Apnea 3 Total Research 28 7 Unmatched validation of clinical efficacy and versatility 4 CardioNet, Inc. 2009

5 Landmark Clinical Study for MCOT The Diagnosis of Cardiac Arrhythmias: A Prospective, Multi-Center, Randomized Study Comparing Mobile Cardiac Outpatient Telemetry versus Standard LOOP Event Monitoring Journal of Cardiovascular Electrophysiology Vol. 18, Number 3, March center, 300 patient multi-center prospective randomized study Largest prospective study ever completed for outpatient cardiac monitoring Design: Patients experiencing palpitations, syncope or presyncope with non-diagnostic Holter within 45 days were randomized to CardioNet MCOT or LOOP event monitoring All Patients: CardioNet MCOT proven to be nearly 3x superior at detecting clinically significant arrhythmias (41% v. 15%) Subset: CardioNet nearly 3x more effective at detecting clinically significant Atrial Fibrillation (AF) (23% v. 8%) CardioNet MCOT proven to be nearly 3x superior at detecting clinically significant cardiac arrhythmias 5 CardioNet, Inc. 2009

6 CardioNet Milestones ($ in millions) $200 $180 January 2009: Category I CPT Code August 2008: Secondary Offering ($26.50) $170 $175 $160 $140 $120 February 2002: FDA Clearance March 2008: Initial Public Offering ($18) Q1 07: PDSHeart acquisition 3x Clinical Study published $120.5 $100 Revenue $80 $ : Secure initial customers Secure initial reimbursement $54.8 $73.0 $77.1 $40 $20 $7.9 $22.2 $30.9 $33.9 $ GAAP Reported Pro Forma for PDS Heart Acquisition Guidance 6 CardioNet, Inc. 2009

7 Clinical Case Studies 7 CardioNet, Inc. 2009

8 Case 1 62-year-old female with episodes of palpitations lasting for a few seconds followed by lightheadedness. Episodes have been occurring for several years. Several of her EKGs in clinic showed normal rhythm. Holter and event monitoring did not show any arrhythmias. Patient was being treated with Paxil, an anti-depressant, by her primary care physician for the last 7 years. She self-referred herself and the first thing that she mentioned was I am not a crazy woman that needs to be on Paxil. 8 CardioNet, Inc. 2009

9 Normal Sinus Rhythm 9 CardioNet, Inc. 2009

10 Atrial Fibrillation 10 CardioNet, Inc. 2009

11 2:1 Atrial Flutter 11 CardioNet, Inc. 2009

12 Atrial Flutter with Variable Conduction 12 CardioNet, Inc. 2009

13 Conversion Pauses-From AF to Sinus rhythm (Lightheadedness following episodes of palpitations) 13 CardioNet, Inc. 2009

14 Treatment Anti-depressant therapy was stopped Anti-arrhythmic and B-blocker therapy initiated Patient was asymptomatic within a few weeks and returned to her exercise program which she was not able to perform prior to appropriate therapy initiation 14 CardioNet, Inc. 2009

15 Case 2 80-year-old lady with history of paroxysmal atrial fibrillation had worsening shortness of breath, fatigue and dizziness. Routine workup including echocardiogram and nuclear stress test were normal. She was enrolled on CardioNet MCOT and during monitoring a serious, life-threatening condition was captured Because of her vague symptoms, her diagnosis could have been delayed or not diagnosed without CardioNet MCOT monitoring 15 CardioNet, Inc. 2009

16 Sinus Bradycardia w/ Prolonged PR interval-1 st degree AVB 16 CardioNet, Inc. 2009

17 Sinus Bradycardia with 3.2 Second Pause 17 CardioNet, Inc. 2009

18 Several Long Pauses (4.5 Seconds) 18 CardioNet, Inc. 2009

19 Treatment: Her life was saved with a pacemaker 19 CardioNet, Inc. 2009

20 Case 3 85-year-old female with a history of arrhythmia, COPD, and anemia due to chronic disease. She has been taking Quinidine (a rhythm medication) since 1991 for Atrial Fibrillation (AF), the diagnosis that she has carried since She developed lung toxicity from Quinidine requiring oxygen therapy and was not longer able to perform her daily activities. Because I could not find any documented AF rhythm I followed my principle: Don t believe it until you see it! 20 CardioNet, Inc. 2009

21 Regular Supra-ventricular Tachycardia (SVT) 21 CardioNet, Inc. 2009

22 Narrow complex short R-P tachycardia-avnrt 22 CardioNet, Inc. 2009

23 Treatment Quinidine was stopped and SVT was treated with an ablation procedure. Her shortness of breath resolved and she no longer required oxygen. She is back to her regular exercise program. CardioNet MCOT ECGs showed short RP tachycardia that supplemented the diagnosis of AVNRT during invasive EP study. 23 CardioNet, Inc. 2009

24 Thank You 24 CardioNet, Inc. 2009