Affiliations.
* Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, “Sapienza” University of Rome, Italy.
† Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, Austin, Texas.
‡ Department of Translational and Precision Medicine, Sapienza University of Rome, Italy.
§ Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, Austin, Texas; Interventional Electrophysiology, Scripps Clinic, La Jolla, California; Department of Cardiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio; Division of Cardiology, Stanford University, Stanford, California; Dell Medical School, University of Texas, Austin, Texas.
Disclosures: Dr. Natale has received speaker honoraria from Boston Scientfic, Biosense Webster, St. Jude Medical, Biotronik, and Medtronic; and is a consultant for Biosense Webster, St. Jude Medical, and Janssen. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Address for Correspondence: Carlo Lavalle, MD. Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155-00161 Rome, Italy. Tel: +39335376901. E-mail address: carlo.lavalle@uniroma1.it
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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.
Key Words: COVID-19, Cardiac Implantable Electronic Device, Remote Monitoring, CIED, GAD-7.