Cardiology Department, Santa Chiara Hospital, Trento, Italy.
Europace. 2012 Mar;14(3):345-50. doi: 10.1093/europace/eur334. Epub 2011 Nov 11.
The increasing volume of pacemaker (PM) and implantable cardioverter defibrillator (ICD) implants and problems related to their functioning have highlighted the issue of device follow-ups. Patients' convenience regarding device visits has been little investigated. This work aims at surveying patients' efforts in attending the in-office PM/ICD follow-ups and at evaluating their expectations.
In four Italian referral centres, over a 3-month period, a 20-point questionnaire was completed by all consecutive patients at in-hospital PM/ICD visits. In total, 1109 questionnaire/patients were evaluated. Pacemakers were 68%, ICDs 16%, and cardiac resynchronizations (CRTs) (PM + ICD) 16%; 38% were females; mean age was 75 ± 11 years. Almost all were scheduled visits. There was frequent reprogramming and clinical examination, even after 6 months from implant. Perceived inconvenience for the in-office follow-up was relevant in 35% of cases; attitudes towards remote monitoring were positive in 88% of cases. Inter-group analysis showed some significant difference: PM patients were older and more frequently female; ICD carriers were younger, had the highest rate of clinical evaluation, a longer journey time, and the most positive opinion about remote follow-up. Cardiac resynchronization patients had a longer waiting time and the lowest inconvenience. Overall inconvenience was independently predicted by increasing age, lengthy travelling times, and being accompanied; favourable opinions about remote monitoring were predicted by overall inconvenience, and, in ICD carriers only, by lack of clinical examination.
Patients' perceptions of in-hospital PM/ICD visits were affected by age and by journey modalities. Individual factors seem to affect both opinions about in-office visits and expectations towards a possible remote follow-up.
起搏器 (PM) 和植入式心脏复律除颤器 (ICD) 植入数量的增加以及与它们功能相关的问题突出了设备随访的问题。患者对设备就诊的便利性尚未得到充分研究。这项工作旨在调查患者在参加门诊 PM/ICD 随访方面的努力，并评估他们的期望。
在四个意大利转诊中心，在 3 个月的时间内，所有连续住院的 PM/ICD 就诊患者都填写了一份 20 分的问卷。总共评估了 1109 份问卷/患者。起搏器占 68%，ICD 占 16%，心脏再同步治疗 (PM+ICD) 占 16%；38%为女性；平均年龄为 75±11 岁。几乎所有的都是预约就诊。即使在植入后 6 个月，也经常进行程控和临床检查。35%的患者认为门诊随访不方便；88%的患者对远程监测持积极态度。组间分析显示存在一些显著差异：PM 患者年龄较大，女性比例较高；ICD 携带者年龄较小，临床评估率最高，就诊时间较长，对远程随访的评价最积极。心脏再同步治疗患者的等待时间更长，不便程度最低。总体不便程度独立预测因素为年龄增加、长途旅行时间和有人陪同；对远程监测的有利意见由总体不便程度预测，而在 ICD 携带者中，仅由缺乏临床检查预测。
患者对门诊 PM/ICD 就诊的看法受到年龄和旅行方式的影响。个体因素似乎同时影响对门诊就诊的看法和对可能的远程随访的期望。
