Management of Cardiac Implantable Electronic Device Follow-Up in
COVID-19 Pandemic: Lessons Learnt During Italian Lockdown
Introduction: Remote monitoring (RM) has profoundly transformed the
standard of care for patients with cardiac electronic implantable
devices. It provides easy access to valuable information about
arrhythmic events, acute decompensation manifestations and
device-related issues without the need of continuous in-person visits.
Methods: Starting March 1st, 332 patients were introduced to a RM
program during the Italian lockdown in order to limit the risk of
in-hospital exposure to Severe Acute Respiratory Syndrome Coronavirus-2.
Patients were categorized in 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, reported
as the mean RM Activation Time (AT) and the need for technical support
for its activation. Patients’ acceptance and anxiety status was also
quantified by means of the Home Monitoring Acceptance and Satisfaction
Questionnaire and the Generalized Anxiety Disorder 7-item scale.
Results: AT time was <48 hours in 93% of patients and 7% of
them required further technical support. Despite a higher number of
trans-telephonic technical support in home-delivered RM group, AT was
comparable between groups (1.33±0.83 days in home-delivered vs 1.28±0.81
days in office-delivered patients; p=0.60). Twenty-eight (2.5%)
urgent/emergent in-person examinations were planned. High degree of
patient’s satisfaction was reached in both groups while anxiety status
was higher in office-delivered group. Conclusions: RM was effective,
safe and well tolerated by patients during the Italian lockdown. Our
findings confirm the efficacy of this approach to reduce in-hospital
visits, guaranteeing patients’ safety and quality of care.