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García-Fernández FJ, Calvo Simal S, Cano Pérez Ó, Calvo Cuervo D, Pombo Jiménez M, Fernández Lozano I, Villagraz Tercedor L, Fernández Palacios G, Martín González J. Impact of the COVID-19 pandemic on implantation of cardiac implantable electronic devices and remote monitoring activations. Rev Esp Cardiol (Engl Ed) 2024; 77:243-253. [PMID: 37516312 DOI: 10.1016/j.rec.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/07/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION AND OBJECTIVES Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) is considered more reliable, efficient, and safer than conventional in-person follow-up. However, the implementation of RM is still suboptimal. This study aimed to analyze the impact of the COVID-19 pandemic on the rates of CIED implants and RM activations in Spain. METHODS The COVID-19 RM Spain Registry was used to analyze the monthly number of all CIED implantations and RM activations from January 2018 to December 2021. A descriptive analysis was performed using aggregated data from the five major CIED manufacturers. RESULTS A total of 205 345 CIEDs were recorded. The number of implants decreased sharply (48.2%) during the pandemic lockdown (March-June 2020) but gradually increased thereafter, compensating for the previous reduction. However, pacemakers and implantable cardiac defibrillators (ICD) showed an aggregate loss of 7% and 3%, respectively, from the annual average during 2020-2021. In contrast, cardiac resynchronization therapy defibrillators (CRT-D) increased by 17%, and pacemakers (CRT-P) by 4.5% over the 2-year period. The percentage of RM activations increased from 24.5% in 2018 to 49.0% in 2021, with a sharp increase during the lockdown. The RM activation rates consistently increased during the lockdown for all devices: pacemakers (14.4% vs 37.2%; P <.001); ICD (75.6% vs 94.2%; P <.001); CRT-D/CRT-P (68.6-44.2% vs 81.6-61%; P <.001), and implantable loop recorders (50.2% vs 68.7%; P <.001). CONCLUSIONS The significant decline in implants during the lockdown gradually recovered, except for pacemakers and ICD. However, the COVID-19 pandemic boosted RM for all CIEDs in Spain.
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Affiliation(s)
- F J García-Fernández
- Unidad de Arritmias, Servicio de Cardiología., Hospital Universitario de Burgos, Burgos, Spain.
| | - Sara Calvo Simal
- Unidad de Investigación, Fundación Burgos por las Ciencias de la Salud, Universidad de Burgos, Burgos, Spain
| | - Óscar Cano Pérez
- Unidad de Arritmias, área de Enfermedades Cardiovasculares, Hospital Universitari i Politècnic La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - David Calvo Cuervo
- Unidad de Arritmias, Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain
| | - Marta Pombo Jiménez
- Unidad de Arritmias, Servicio de Cardiología, Hospital Costa del Sol, Marbella, Málaga, Spain
| | - Ignacio Fernández Lozano
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Lola Villagraz Tercedor
- Unidad de Arritmias, Servicio de Cardiología., Hospital Universitario de Burgos, Burgos, Spain
| | | | - Javier Martín González
- Unidad de Arritmias, Servicio de Cardiología., Hospital Universitario de Burgos, Burgos, Spain
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Crespo-Leiro MG, Segovia-Cubero J, González-Costello J, Bayes-Genis A, López-Fernández S, Roig E, Sanz-Julve M, Fernández-Vivancos C, de Mora-Martín M, García-Pinilla JM, Varela-Román A, Almenar-Bonet L, Lara-Padrón A, de la Fuente-Galán L, Delgado-Jiménez J. Adherence to the ESC Heart Failure Treatment Guidelines in Spain: ESC Heart Failure Long-term Registry. ACTA ACUST UNITED AC 2015; 68:785-93. [PMID: 26003504 DOI: 10.1016/j.rec.2015.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 03/11/2015] [Indexed: 12/20/2022]
Abstract
INTRODUCTION AND OBJECTIVES To estimate the percentage of heart failure patients in Spain that received the European Society of Cardiology recommended treatments, and in those that did not, to determine the reasons why. METHODS The study included 2834 consecutive ambulatory patients with heart failure from 27 Spanish hospitals. We recorded general information, the treatment indicated, and the reasons why it was not prescribed in some cases. In patients who met the criteria to receive a certain drug, true undertreatment was defined as the percentage of patients who, without justification, did not receive the drug. RESULTS In total, 92.6% of ambulatory patients with low ejection fraction received angiotensin converting enzyme inhibitors or angiotensin receptor blockers, 93.3% beta-blockers, and 74.5% mineralocorticoid receptor antagonists. The true undertreatment rates were 3.4%, 1.8%, and 19.0%, respectively. Target doses were reached in 16.2% of patients receiving angiotensin converting enzyme inhibitors, 23.3% of those with angiotensin receptor blockers, 13.2% of those prescribed beta-blockers, and 23.5% of those with mineralocorticoid receptor antagonists. Among patients who could benefit from ivabradine, 29.1% received this drug. In total, 36% of patients met the criteria for defibrillator implantation and 90% of them had received the device or were scheduled for implantation, whereas 19.6% fulfilled the criteria for resynchronization therapy and 88.0% already had or would soon have the device. In patients who met the criteria, but did not undergo device implantation, the reasons were not cost-related. CONCLUSIONS When justified reasons for not administering heart failure drugs were taken into account, adherence to the guideline recommendations was excellent. Exclusive use of the percentage of treated patients is a poor indicator of the quality of healthcare in heart failure. Measures should be taken to improve the attainment of optimal dosing in each patient.
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Affiliation(s)
- María G Crespo-Leiro
- Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), A Coruña, Spain.
| | - Javier Segovia-Cubero
- Unidad de Insuficiencia Cardiaca Avanzada, Trasplante e Hipertensión Pulmonar, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - José González-Costello
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante, Servicio de Cardiología, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Antoni Bayes-Genis
- Servicio de Cardiología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Silvia López-Fernández
- Unidad de Insuficiencia Cardiaca, Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Eulàlia Roig
- Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Marisa Sanz-Julve
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante, Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Manuel de Mora-Martín
- Unidad de Gestión del Corazón y Enfermedades Cardiovasculares, Servicio de Cardiología, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - José Manuel García-Pinilla
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Área de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Alfonso Varela-Román
- Servicio de Cardiología, Hospital Clínico Universitario Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Luis Almenar-Bonet
- Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Antonio Lara-Padrón
- Servicio de Cardiología, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - Luis de la Fuente-Galán
- Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Juan Delgado-Jiménez
- Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain
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