Scalvini Simonetta, Zanelli Emanuela, Volterrani Maurizio, Martinelli Giovanna, Baratti Doriana, Buscaya Osvaldo, Baiardi Paola, Glisenti Fulvio, Giordano Amerigo
Fondazione S Maugeri, Divisione di Cardiologia, Instituto di Ricovero e Cura a Carattere Scientifico, Gussago, Brescia, Italy.
J Telemed Telecare. 2004;10(2):113-7. doi: 10.1258/135763304773391576.
We assessed the feasibility of home-based telecardiology for patients with chronic heart failure (CHF). Seventy-four CHF patients were enrolled into a programme of telephone follow-up and single-lead electrocardiography (ECG) monitoring. The patients transmitted their ECG data by fixed telephone line to a receiving station, where a nurse was available for an interactive teleconsultation. Patients were followed up for a mean (SD) of 307 (108) days; 1467 calls were analysed (213 ad hoc consultations and 1254 scheduled consultations). A total of 124 cardiovascular events were recorded. Modifications to therapy were suggested in response to 119 calls; hospital admissions were suggested for 13 patients, further investigations for 7 and a consultation with the patient's general practitioner for 13. No action was taken after 1330 calls. Twenty-two ECG abnormalities were recorded. In 63 patients receiving the beta-blocker carvedilol, the mean dosage increased from 36 to 42 mg. In the previous year there were 1.8 hospitalizations per patient, while in the follow-up period there were 0.2 hospitalizations per patient. Following up CHF patients using a nurse-led telecardiology programme seems to be feasible and useful.
我们评估了针对慢性心力衰竭（CHF）患者开展家庭远程心脏病学服务的可行性。74名CHF患者被纳入一个电话随访和单导联心电图（ECG）监测项目。患者通过固定电话线将其ECG数据传输至一个接收站，在那里有一名护士提供交互式远程会诊服务。对患者进行了平均（标准差）307（108）天的随访；分析了1467次通话（213次临时会诊和1254次定期会诊）。共记录到124次心血管事件。针对119次通话提出了治疗调整建议；建议13名患者住院，7名患者进一步检查，13名患者与患者的全科医生会诊。1330次通话后未采取任何行动。记录到22例ECG异常。在63名接受β受体阻滞剂卡维地洛治疗的患者中，平均剂量从36毫克增加到42毫克。上一年每位患者平均住院1.8次，而在随访期间每位患者平均住院0.2次。使用由护士主导的远程心脏病学项目对CHF患者进行随访似乎是可行且有用的。
