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.