Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy.
Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, Texas, USA.
J Cardiovasc Electrophysiol. 2020 Nov;31(11):2814-2823. doi: 10.1111/jce.14755. Epub 2020 Sep 30.
Remote monitoring (RM) has significantly transformed the standard of care for patients with cardiac electronic implantable devices. It provides easy access to valuable information, such as arrhythmic events, acute decompensation manifestations and device-related issues, without the need of in-person visits.
Starting March 1st, 332 patients were introduced to an RM program during the Italian lockdown to limit the risk of in-hospital exposure to severe acute respiratory syndrome-coronavirus-2. Patients were categorized into two groups based on the modality of RM delivery (home [n = 229] vs. office [n = 103] delivered). The study aimed at assessing the efficacy of the new follow-up protocol, assessed as mean RM activation time (AT), and the need for technical support. In addition, patients' acceptance and anxiety status were quantified via the Home Monitoring Acceptance and Satisfaction Questionnaire and the Generalized Anxiety Disorder 7-item scale.
AT time was less than 48 h in 93% of patients and 7% of them required further technical support. Despite a higher number of trans-telephonic technical support in the home-delivered RM group, mean AT was similar between groups (1.33 ± 0.83 days in home-delivered vs 1.28 ± 0.81 days in office-delivered patients; p = .60). A total of 28 (2.5%) urgent/emergent in-person examinations were required. A high degree of patient satisfaction was reached in both groups whereas anxiety status was higher in the office-delivered group.
The adoption of RM resulted in high patient satisfaction, regardless of the modality of modem delivery; nonetheless, in-office modem delivery was associated with a higher prevalence of anxiety symptoms.
远程监测（RM）显著改变了心脏电子植入设备患者的护理标准。它提供了方便获取有价值信息的途径，如心律失常事件、急性失代偿表现和与设备相关的问题，而无需进行面对面的就诊。
从 3 月 1 日起，为了限制因严重急性呼吸综合征冠状病毒 2 而在医院暴露的风险，332 名患者开始参与一个 RM 计划。患者根据 RM 传递方式（家庭[ n = 229]与办公室[ n = 103]）分为两组。该研究旨在评估新的随访方案的效果，评估指标为平均 RM 激活时间（AT）和对技术支持的需求。此外，通过家庭监测接受和满意度问卷和广泛性焦虑障碍 7 项量表来量化患者的接受程度和焦虑状况。
93%的患者的 AT 时间小于 48 小时，其中 7%的患者需要进一步的技术支持。尽管家庭传递 RM 组需要更多的电话技术支持，但两组的平均 AT 相似（家庭传递组为 1.33±0.83 天，办公室传递组为 1.28±0.81 天； p = 0.60）。总共需要 28 次（2.5%）紧急/紧急的当面检查。两组患者均达到了较高的满意度，而办公室传递组的焦虑状况较高。
无论传递方式如何，采用 RM 均可获得较高的患者满意度；然而，在办公室传递方式下，焦虑症状的发生率更高。
