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Magnocavallo M, Vetta G, Bernardini A, Piro A, Mei MC, Di Iorio M, Mariani MV, Della Rocca DG, Severino P, Quaglione R, Giunta G, Chimenti C, Miraldi F, Vizza CD, Fedele F, Lavalle C. Impact of COVID-19 Pandemic on Cardiac Electronic Device Management and Role of Remote Monitoring. Card Electrophysiol Clin 2022; 14:125-131. [PMID: 35221081 PMCID: PMC8556573 DOI: 10.1016/j.ccep.2021.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
During the coronavirus disease 2019 (COVID-19) worldwide pandemic, patients with cardiac implantable electronic device (CIED) refused scheduled follow-up visits because of the risk of infection. In this scenario, different telemedicine strategies have been implemented to ensure continuity of care to CIED patients. Patients can be monitored through dedicated applications, telephone calls, or virtual visits providing easy access to valuable information, such as arrhythmic events, acute decompensation manifestations, and device-related issues, without the need for in-person visits. This review provides a comprehensive description of the many possible applications of telemedicine for CIED patients during the COVID-19 period.
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Affiliation(s)
- Michele Magnocavallo
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 720, Austin, TX 78705, USA
| | - Giampaolo Vetta
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Alessia Bernardini
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Agostino Piro
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Maria Chiara Mei
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Martina Di Iorio
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Marco Valerio Mariani
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Domenico G Della Rocca
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 720, Austin, TX 78705, USA
| | - Paolo Severino
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Raffaele Quaglione
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Cristina Chimenti
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Fabio Miraldi
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Carmine Dario Vizza
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Francesco Fedele
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Carlo Lavalle
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
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Bernardini A, Magnocavallo M, Mariani MV, Mei MC, Di Iorio M, Vetta G, Piro A, Trivigno S, Giunta G, Chimenti C, Nicosia A, Adduci C, Grossi S, Saporito D, Quaglione R, Rapacciuolo A, Marini M, Santarpia G, Pentimalli F, Rordorf R, Vaccaro P, Campari M, Valsecchi S, Fedele F, Lavalle C. 281 Home delivery of the communicator for remote monitoring of cardiac implantable devices: a multicentre experience during the COVID-19 lockdown. Eur Heart J Suppl 2021. [PMCID: PMC8689764 DOI: 10.1093/eurheartj/suab135.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Aims During the COVID-19 pandemic in-person visits for patients with cardiac implantable electronic devices should be replaced by remote monitoring (RM), in order to prevent viral transmission. A direct home-delivery service of the RM communicator has been implemented at 49 Italian arrhythmia centres. Methods and results According to individual patient preference or the organizational decision of the centre, patients were assigned to the home-delivery group or the standard in-clinic delivery group. In the former case, patients received telephone training on the activation process and use of the communicator. In June 2020, the centres were asked to reply to an ad hoc questionnaire to describe and evaluate their experience in the previous 3 months. RM was activated in 1324 patients: 821 (62%) received the communicator at home and the communicator was activated remotely. Activation required one additional call in 49% of cases, and the median time needed to complete the activation process was 15 min (25th–75th percentile: 10–20). 753 (92%) patients were able to complete the correct activation of the system. At the time when the questionnaire was completed, 743 (90%) communicators were regularly transmitting data. The service was generally deemed useful (96% of respondents) in facilitating the activation of RM during the COVID-19 pandemic and possibly beyond. Conclusions Home delivery of the communicator proved to be a successful approach to system activation, and received positive feedback from clinicians. The increased use of a RM protocol will reduce risks for both providers and patients, while maintaining high-quality care.
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Affiliation(s)
- Alessia Bernardini
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Michele Magnocavallo
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Marco Valerio Mariani
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Chiara Mei
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Martina Di Iorio
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Giampaolo Vetta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Agostino Piro
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Sara Trivigno
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Cristina Chimenti
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Carmen Adduci
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Stefano Grossi
- Cardiology Department, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy
| | | | - Raffaele Quaglione
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Rapacciuolo
- Cardiology Unit, Università degli Studi di Napoli Federico II, Naples, Italy
| | | | - Giuseppe Santarpia
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | | | - Roberto Rordorf
- Department of Cardiology, Fondazione IRCCS Policlinico S. Matteo Pavia, Italy
| | - Paola Vaccaro
- Cardiology Unit, Riuniti Hospital, P.O. Cervello, Palermo, Italy
| | | | | | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Carlo Lavalle
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
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Piro A, Magnocavallo M, Vetta G, Bernardini A, Mariani MV, Chimenti C, Giunta G, Trivigno S, Di Iorio M, Mei MC, Severino P, Straito M, Iannucci G, Neccia M, Rocca DGD, Manzi G, Quaglione R, Natale A, Fedele F, Lavalle C. 269 Management of cardiac implantable electronic device follow-up in COVID-19 pandemic: lessons learned during Italian lock down. Eur Heart J Suppl 2021. [PMCID: PMC8689771 DOI: 10.1093/eurheartj/suab146.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aims Remote monitoring (RM) has significantly transformed the standard of care for patients with cardiac electronic implantable devices. It provides easy access to valuable information, such as arrhythmic events, acute decompensation manifestations, and device‐related issues, without the need of in‐person visits. Methods and results Starting 1 March, 332 patients were introduced to an RM programme during the Italian lockdown to limit the risk of in‐hospital exposure to severe acute respiratory syndrome‐coronavirus‐2. Patients were categorized into two groups based on the modality of RM delivery [home (n = 229) vs. office (n = 103) delivered]. The study aimed at assessing the efficacy of the new follow‐up protocol, assessed as mean RM activation time (AT), and the need for technical support. In addition, patients’ acceptance and anxiety status were quantified via the Home Monitoring Acceptance and Satisfaction Questionnaire and the Generalized Anxiety Disorder 7‐item scale. AT time was less than 48 h in 93% of patients and 7% of them required further technical support. Despite a higher number of trans‐telephonic technical support in the home‐delivered RM group, mean AT was similar between groups (1.33 ± 0.83 days in home‐delivered vs. 1.28 ± 0.81 days in office‐delivered patients; P = 0.60). A total of 28 (2.5%) urgent/emergent in‐person examinations were required. A high degree of patient satisfaction was reached in both groups whereas anxiety status was higher in the office‐delivered group. Conclusions The adoption of RM resulted in high patient satisfaction, regardless of the modality of modem delivery; nonetheless, in‐office modem delivery was associated with a higher prevalence of anxiety symptoms.
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Affiliation(s)
- Agostino Piro
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Michele Magnocavallo
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Giampaolo Vetta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Alessia Bernardini
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Marco Valerio Mariani
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Cristina Chimenti
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Sara Trivigno
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Martina Di Iorio
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Maria Chiara Mei
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Paolo Severino
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Martina Straito
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Gino Iannucci
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Matteo Neccia
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | | | - Giovanni Manzi
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Raffaele Quaglione
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Andrea Natale
- St David’s Medical Center, Texas Cardiac Arrhythmia Institute, Austin, TX, USA
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Carlo Lavalle
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
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