Unstructured Abstract
COVID-19 pandemic has caused a necessary reorganization of the elective
outpatient device clinic.
Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs)
has been validated as a safe and effective tool to follow patients,
limiting the need for in-person visits.
We provided a snapshot of the current clinical practice in a tertiary
electrophysiology center in Italy, suggesting a potential model of care
for patients with CIEDs.
Before the COVID-19 pandemic, patients with implantable cardioverter
defibrillators/cardiac resynchronization therapy (ICD/CRTs) were
evaluated in the device clinic twice a year and patients with pacemakers
(PMs) once a year; loop recorder (ILR) patients were followed remotely
only. In the COVID-19 period RM was implemented for all compatible
CIEDs. Patients with RM were not seen in clinic anymore and were
followed with RM.
In the COVID-19 period, 100% of newly implanted devices received RM (82
ILR, 194 PMs, 80 ICDs/CRTs), compared to 68% in the same months of 2019
(106/106 ILR, 83/203 PMs, 78/82 ICD/CRTs), p<0.01. Moreover,
502 previously implanted patients with RM compatible devices were
contacted and received RM. By the end of February 2021, 1676 patients
were remotely monitored at our Institution, with a potential saving of
outpatient visits of 1683 visits/year, against an average of 8514 RM
transmissions/year needing evaluation.
RM of CIEDs is essential to reduce in-person visits during the COVID-19
pandemic. The potential for elective outpatient appointments reduction
has to be counterbalanced by the sustainability of a large number of
transmissions and data to analyze.
Key Words: COVID-19, Remote monitoring, Cardiac implantable
electronic devices, Device clinic, Cardiac pacing