The Role of Telecardiology in Dealing with Patients with Cardiac Rhythm Disorders in Family Medicine – Systematic Review

Abstract

PurposeHeart rhythm disorders (HRD) are often present in patients visiting their family physician (FP). Dealing with their problems is not always simple, efficient and cost effective. The aim of this paper is to review the existing literature about the use and experience of telecardiology in patients experiencing HRD.MethodsWe conducted a review of literature in PubMed biographical databases (MeSH thesaurus), Web of Science and Cochrane, between 1995 and 2019. We included original articles in English that describe the use of telecardiology at primary and secondary healthcare levels. Exclusion criteria are those publications that discuss heart failure or observation of the activity of pacemakers or defibrillators and the age of patients under 18 years. A total of 19 papers met the inclusion criteria, thirteen of them were original scientific articles and we included them in the analysis.ResultsUse of telemedicine can shorten the time from diagnosis to the necessary treatment (2/13), telemedicine can reduce mortality in patients with acute myocardial infarction (4/13), it can shorten the time to diagnose atrial fibrillations (4/13), it can help determine the diagnosis for patients complaining about heart rhythm disorders which were not detected on the standard ECG recording (2/13) and can also help identify cardiac causes for syncope or collapse (2/13). All studies have confirmed that the use of telecardiology significantly reduces the number of unnecessary referrals to a cardiologist or hospitalization, and shortens the time needed to treat patients with life-threatening conditions.ConclusionThe use of telecardiological techniques increases the quality and safety of work in managing patients with cardiovascular disease in FP practice. Usage of telecardiologic devices can also save money and bridge the gap between the primary and secondary healthcare levels.

Clinicians perceptions of a telemedicine system: a mixed method study of Makassar City, Indonesia

“…There is extensive literature regarding telecardiology and teleultrasound diagnosis effectiveness. Vodicka et al in a systematic review regarding telecardiology in Slovenia concluded that telecardiology significantly reduces the number of unnecessary referrals to a cardiologist or hospitalization, and shortens the time needed to treat patients with life-threatening conditions [21]. Britton et al in a systematic review showed that teleultrasound provided satisfactory quality and value for clinical diagnosis and management [22].…”

Telemonitoring of elderly with hypertension and type 2 diabetes at the primary care level: Protocol for a multicentric randomized controlled pilot study

“…Telemonitoring is a subset of telemedicine and refers to the transmission of physiological data, such as BP and BG values, via automated electronic means or via web-based or telephone data. The data received allows physicians to interpret the data synchronously and make timely decisions about the patient's treatment (5)(6)(7). Currently, telemonitoring is often combined with teleconsultations, which can be synchronous via videoconferencing devices or asynchronous via email, internet, or mobile phones (5)(6)(7).…”

“…The data received allows physicians to interpret the data synchronously and make timely decisions about the patient's treatment (5)(6)(7). Currently, telemonitoring is often combined with teleconsultations, which can be synchronous via videoconferencing devices or asynchronous via email, internet, or mobile phones (5)(6)(7). The combination of frequent BP/BG measurements and timely feedback/consultation from the registered nurse or physician is the main reason why telemonitoring has the potential to significantly improve clinical outcomes (5)(6)(7)(8).…”

Differences in Treating Patients with Palpitations at the Primary Healthcare Level Using Telemedical Device Savvy before and during the COVID-19 Pandemic

“…Many studies have been conducted on efficiently diagnosing such patients through telemedical approaches or remote consultations [ 16 , 17 ]. Remote consultations can be very useful in general practice because the patient and their GP need not to be at the same place at the same time [ 18 ].…”

“…This concept was developed in 1980s in order to provide healthcare to patients who live in remote areas [ 19 ] and has been shown to be very useful in times of lockdown—such as the COVID-19 pandemic [ 20 ]—when patients are not allowed to visit their GP due to restrictions [ 21 ] or are not comfortable doing so because of their fear of being infected with the virus [ 22 ]. Various low-cost sensors have been used to record the physiological parameters of patients, such as body temperature, heart rate, oxygenation of blood, and blood pressure [ 16 , 17 , 23 ]. Sensors are connected, by Wi-Fi or Bluetooth, to a smart phone or tablet and can be managed using different applications [ 24 ].…”