Challenges in activation of remote monitoring in patients with cardiac rhythm devices during the coronavirus (COVID-19) pandemic

Abstract

Background Remote monitoring (RM) technology embedded in cardiac rhythm devices permits continuous monitoring of device function, and recording of selected cardiac physiological parameters and cardiac arrhythmias and may be of utmost utility during Coronavirus (COVID-19) pandemic, when in-person office visit for regular follow-up were postponed. However, patients not alredy followed-up via RM represent a challenging group of patients to be managed during the lockdown. Methods We reviewed patient files scheduled for an outpatient visit between January 1, 2020 and May 11th, 2020 to assess the proportion of patients in whom RM activation was possible without office visit, and compared them to those scheduled for visit before the lockdown. Results During COVID-19 pandemic, RM activation was feasible in a minority of patients (7.8% of patients) expected at outpatient clinic for a follow-up visit and device check-up. This was possible in a good proportion of complex implantable devices such as cardiac resynchronization therapy and implantable cardioverter defibrillator but only in 3 patients with a pacemaker the RM function could be activated during the period of restricted access to hospital. Conclusions Our experience strongly suggest to consider the systematic activation of RM function at the time of implantation or – by default programming - in all cardiac rhythm management devices.

Home delivery of the communicator for remote monitoring of cardiac implantable devices: A multicenter experience during the covid‐19 lockdown

“…As also reported in several studies, not only does RM play a central role in preventing hospitalizations and improving survival and quality of life in patients with CIEDs, it is also a cost‐effective alternative to in‐person evaluations 16–25 . Overall, in the context of the COVID‐19 emergency, the improvement of RM coverage has facilitated continuous patient assistance and significantly reduced the risk of virus transmission among both more vulnerable populations and healthcare providers 26–28 …”

“…[16][17][18][19][20][21][22][23][24][25] Overall, in the context of the COVID-19 emergency, the improvement of RM coverage has facilitated continuous patient assistance and significantly reduced the risk of virus transmission among both more vulnerable populations and healthcare providers. [26][27][28] Our Italian multicenter study involved patients from different cen- were monitoring at least 50 patients via this system. The increased number of patients enrolled was achieved thanks to the competence of the staff and their ability to reinforce patients' feeling of being constantly assisted, both technically and clinically.…”

“…[16][17][18][19][20][21][22][23][24][25] Overall, in the context of the COVID-19 emergency, the improvement of RM coverage has facilitated continuous patient assistance and significantly reduced the risk of virus transmission among both more vulnerable populations and healthcare providers. [26][27][28] Our Italian multicenter study involved patients from different centers located in areas with different degrees of exposure to COVID-19, with 29 (59%) of 49 centers being located in regions with a moderatehigh incidence of COVID-19 cases. A large number of patients were rapidly introduced to RM: the LATITUDE system was activated in 1324 patients, 821 (62%) of whom received the communicator at home, while 503 (38%) received it in hospital.…”

Remote monitoring of pacemakers and defibrillators: Effective and safe in Brazil?

“…The way the medical service responds to alerts also has a great impact on outcomes; however, this requires adequate organization and resources in these centers to promote effective and immediate follow up. 24 , 25 , 26 …”

Impact of remote monitoring in heart failure patients with cardiac implantable electronic devices during COVID-19 pandemic: a single center experience

“…Expert recommendations emphasized the potential benefits of remote monitoring in non-CIED heart failure patient group for potential better and safer patient management during COVID-19 pandemic related healthcare restrictions [8,9] and expert position statements were published for reducing in-office patient evaluation follow-up burden and face-to-face visit events resulting in potential minimised exposure of patients and healthcare workers [8,[10][11][12]. Some authors suggested consequent activation of RM function in all newly implated CIEDs [13], or declared RM as essential in the follow-up of CIED patients during the pandemic [14,15]. Aim of this study was to investigate, wheter symptomatic heart failure patients, with implanted defibrillators (ICD) or cardiac resynchronization therapy pacemakers (CRT-P) or defibrillators (CRT-D) capable to remote follow-up may have clinical benefits in terms of rapid detection of worsening heart failure or other clinival adverse events compared to a conventionally followed (non-monitored) patient group during the special scenario of COVID-19 pandemic.…”