Remote monitoring and telemedicine in heart failure: implementation and benefits

Imberti, Jacopo Francesco; Tosetti, Alberto; Mei, Davide; Maisano, Anna; Boriani, Giuseppe

doi:10.1007/s11886-021-01487-2

Cited by 38 publications

(22 citation statements)

References 107 publications

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“…Of 45 total programs, cardiology has the highest number of absolute frequency (7) followed by endocrinology (6) and psychology (4). The specialties that have two positive answers are rehabilitation/speech therapy, pneumology, psychiatry, vulnology, nephrology, neurology, pediatrics, and gynecology.…”

Section: Resultsmentioning

confidence: 99%

“…This result can be explained by the abundant presence of devices to monitor parameters in chronic patients, especially those affected by heart failure and diabetes. For chronic heart failure, the cardiac implantable electronic devices used to treat bradyarrhythmia and tachyarrhythmia nowadays have been implemented with the feature of remote monitoring, to gather, store, and transmit data regarding the patients’ parameters to clinicians [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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The Prevalence of Teleophthalmology in the Piedmont Region of Italy: Current Situation and Future Perspectives

Nuzzi

Deraco

Scalabrin

2022

IJERPH

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Purpose: This cross-sectional study aims to evaluate the actual prevalence of telemedicine, with a particular attention to teleophthalmology programs, in the Piedmont region of Northern Italy and investigate the prospects of the discipline, comparing the situation with the rest of Italy. Information about the current teleophthalmological development is important to assess the state-of-the-art of innovation in medicine in different areas of the world so that there can be a healthy comparison and evaluation of progress and backlog. Methods: We sent questionnaires to every Local Healthcare Authority and gathered the answers in five distinct categories. Due to the COVID-19 pandemic, we collected information by telephone. We investigated five primary areas: what type of telemedicine services are currently in operation, how they are managed, the presence of any evaluation of patient satisfaction and cost-savings, and the prospects of future teleophthalmology programs to be implemented. Results: Only 2% of the total telemedicine programs are in the field of ophthalmology. The greater parts are in the field of cardiology (15%) and endocrinology (13%). Currently, only one program of teleophthalmology exists in the territory, and at least four more projects are waiting to be approved or funded. Surveys about patient satisfaction were not provided and there was no evidence of cost-saving. Conclusions: Teleophthalmology in Piedmont is slowly developing, although there is a lack of a unified network for storing and managing patients’ data. During the COVID-19 pandemic, telemedicine usage drastically increased, and there is a need to evaluate this trend to understand its place in the future of medicine.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Prevalence of Teleophthalmology in the Piedmont Region of Italy: Current Situation and Future Perspectives

Nuzzi

Deraco

Scalabrin

2022

IJERPH

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“…Our study provides simple clinical parameters that allow the identification of patients at higher risk of incident clinical AF and/or long-lasting AHRE episodes which may warrant closer follow-up visits. In consideration of the risk of stroke/thromboembolic events associated with asymptomatic clinical AF, not different from the risk associated with symptomatic clinical AF [17], prompt initiation of anticoagulation is required in patients at risk who develop clinical AF during follow-up, independently on symptoms, and this stresses the value of close monitoring of patients presenting with AHRE, also with the aid, if possible, of remote monitoring [18]. We found that CHA 2 DS 2 -VASc score was independently associated with the composite outcome of clinical AF and longest AHRE episode ≥24 h and also predicted clinical AF per se.…”

Section: Discussionmentioning

confidence: 99%

Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices: Dynamic Changes in Episodes and Predictors of Incident Atrial Fibrillation

Imberti

Bonini

Tosetti

et al. 2022

Biology

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Background. Atrial high rate episodes (AHRE) detected by cardiac implantable electronic devices (CIEDs) may be associated with a risk of progression towards long-lasting episodes (≥24 h) and clinical atrial fibrillation (AF). Methods. Consecutive CIED patients presenting AHRE (with confirmation of an arrhythmia lasting 5 min–23 h 59 min, atrial rate ≥175/min, with no AF at 12-lead ECG and no prior clinical AF) were retrospectively enrolled. The aims of this study were to describe patients’ characteristics and the incidence of adverse events, and second, to identify potential predictors of the composite outcome of clinical AF and/or AHRE episodes lasting ≥24 h. Results. 104/107 (97.2%) patients (median age 79.7 (74.0–84.2), 33.7% female) had available follow-up data. Over a median follow-up of 24.3 (10.6–40.3) months, 31/104 (29.8%) patients experienced the composite outcome of clinical AF or AHRE episodes lasting ≥24 h. Baseline CHA2DS2-VASc score and the longest AHRE episode at enrollment lasting 12 h–23 h 59 min were independently associated with the composite outcome (Hazard ratio (HR); 95% CI: 1.40; 1.07–1.83 and HR: 8.15; 95% CI 2.32–28.65, respectively). Baseline CHA2DS2-VASc score and the longest AHRE episode at enrollment lasting 12 h–23 h 59 min were the only independent predictors of incident clinical AF (HR: 1.45; 95% CI 1.06–2.00 and HR: 4.25; 95% CI 1.05–17.20, respectively). Conclusions. In patients with AHRE, the incidence of clinical AF or AHRE episodes lasting ≥24 h is high in a two-year follow-up. Baseline patients’ characteristics (CHA2DS2-VASc score) and AHRE duration may help to intensify monitoring and decision-making, being independently associated with clinical AF at follow-up.

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“…There would also be a rush so that patients could quickly send messages to their families. Imberti et al [13] found that device-based remote monitoring (RM) was useful in the early detection of cardiac implantable electronic devices (CIEDs) technical issues and cardiac arrhythmias. Moreover, RM allowed the continuous monitoring of several patients' clinical parameters associated with impending heart failure (HF) decompensation, but there was still uncertainty regarding its effectiveness in reducing mortality and hospitalizations.…”

Section: Related Workmentioning

confidence: 99%

“…GRU uses the update gate to determine the information read from the memory content and the previous unit. The calculation process is shown in formula (10) to formula (13). The GRU model can use the reset gate to store past information.…”

Section: Grumentioning

confidence: 99%

Exploring an Efficient Remote Biomedical Signal Monitoring Framework for Personal Health in the COVID-19 Pandemic

Tang

et al. 2021

IJERPH

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Nowadays people are mostly focused on their work while ignoring their health which in turn is creating a drastic effect on their health in the long run. Remote health monitoring through telemedicine can help people discover potential health threats in time. In the COVID-19 pandemic, remote health monitoring can help obtain and analyze biomedical signals including human body temperature without direct body contact. This technique is of great significance to achieve safe and efficient health monitoring in the COVID-19 pandemic. Existing remote biomedical signal monitoring methods cannot effectively analyze the time series data. This paper designs a remote biomedical signal monitoring framework combining the Internet of Things (IoT), 5G communication and artificial intelligence techniques. In the constructed framework, IoT devices are used to collect biomedical signals at the perception layer. Subsequently, the biomedical signals are transmitted through the 5G network to the cloud server where the GRU-AE deep learning model is deployed. It is noteworthy that the proposed GRU-AE model can analyze multi-dimensional biomedical signals in time series. Finally, this paper conducts a 24-week monitoring experiment for 2000 subjects of different ages to obtain real data. Compared with the traditional biomedical signal monitoring method based on the AutoEncoder model, the GRU-AE model has better performance. The research has an important role in promoting the development of biomedical signal monitoring techniques, which can be effectively applied to some kinds of remote health monitoring scenario.

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Remote monitoring and telemedicine in heart failure: implementation and benefits

Cited by 38 publications

References 107 publications

The Prevalence of Teleophthalmology in the Piedmont Region of Italy: Current Situation and Future Perspectives

The Prevalence of Teleophthalmology in the Piedmont Region of Italy: Current Situation and Future Perspectives

Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices: Dynamic Changes in Episodes and Predictors of Incident Atrial Fibrillation

Exploring an Efficient Remote Biomedical Signal Monitoring Framework for Personal Health in the COVID-19 Pandemic

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