Cardiac Resynchronization Therapy Remote Monitoring – COVID-19 Pandemic Experiences and Future Perspectives

Abstract

Cardiac resynchronization therapy (CRT) is a well established form of the treatment for heart failure (HF) in patients with left ventricle contraction dyssynchrony. Apart from typical in-office management, remote monitoring enables constant surveillance on both the patient's and the device's condition. This way, in case of any problems, clinical decisions could be made earlier leading to better outcome of CRT patients. COVID-19 pandemic with following lockdowns in many countries resulted in getting more attention on remote monitoring systems. The aim of this paper was to gather and summarize worldwide experiences from CRT remote monitoring during COVID-19 pandemic and point out future possibilities for HF patients treated with CRT. Already published experiences from remote monitoring of CRT devices during COVID-19 restrictions confirmed previous advantages of telemedical approach, however more publications in this area would be helpful.

Negative effects of COVID‐19 on the implantation rate of cardiac resynchronization therapy with defibrillator device

“…Providers were able to better predict heart failure exacerbations, detect arrhythmias, identify malfunctions, decrease healthcare visits and costs, and reduce exposure to COVID-19. 4 Alerts from the remote heart failure monitoring system allowed for prompt interventions to prevent further progression and reduce hospitalizations when compared with the traditional in-office CRT-D evaluation. 25 The European Heart Rhythm Association survey before and during the pandemic showed a significant increase in the use of remote monitoring for pacemakers, loop recorders, cardiovascular electronic implantable devices (CEIDs), and CRT-p, as well as a decrease in in-office visits during the pandemic.…”

“…There were also significant positive outcomes from CRT‐D and the increased usage of remote monitoring during the pandemic. Providers were able to better predict heart failure exacerbations, detect arrhythmias, identify malfunctions, decrease healthcare visits and costs, and reduce exposure to COVID‐19 4 . Alerts from the remote heart failure monitoring system allowed for prompt interventions to prevent further progression and reduce hospitalizations when compared with the traditional in‐office CRT‐D evaluation 25 .…”

“…3 As the world adapted, many practitioners switched to telehealth visits and remote monitoring for their patients. 4 Simovic et al conducted an online survey study in 28 European countries and reported a significant increase in remote cardiac implantable electronic device monitoring during the pandemic. 5 Surgical operations began to normalize over the following months.…”

“…Procedure volume dropped considerably during the initial wave of COVID‐19, including those typically associated with life‐saving measures 3 . As the world adapted, many practitioners switched to telehealth visits and remote monitoring for their patients 4 . Simovic et al.…”