Argnani Maria Selina, Tomasi Corrado, Amatulli Nicola, Calderoni Lorena, Castellini Antonella, Dal Monte Alessandro, Drudi Daria, Fabbri Laura, Gianelli Morena, Giannotti Federica, Rigon Monica, Rubino Ida, Smarrazzo Vittorio, Rubboli Andrea
U.O.C. Cardiologia di Ravenna, Faenza e Lugo, Ospedale "S. Maria delle Croci", Ravenna; Azienda Unità Sanitaria Locale della Romagna, Ravenna.
G Ital Cardiol (Rome). 2022 Jan;23(1):4-9. doi: 10.1714/3715.37054.
The COVID-19 pandemic caused by SARS-CoV-2 has greatly modified outpatient follow-ups. The aim of this retrospective study was to evaluate the organizational modalities and clinical effects of rearrangements of pacemaker (PM) and implantable cardioverter-defibrillator (ICD) outpatient visits performed in our centers at Ravenna and Lugo Hospitals, Italy, during the pandemic outbreak in 2020.
All scheduled in-person device follow-up visits in March-December 2020 have been considered. On the basis of documented past functioning of each device and of remote monitoring (RM) capabilities, in-person visits were either performed or postponed at variable times. The characteristics of the follow-ups and the device-related clinically relevant events were analyzed, the latter being further divided into serious malfunction and problems to be corrected by device reprogramming.
Overall, 27% of in-person visits were postponed (n = 576) (36% of ICDs and 25% of PMs), peaking 62% in March-May 2020. RM compensated nearly all hold-ups in ICDs and just 63% of postponements in PMs. The postponement-caused delay between in-person visits was 5.6 ± 1.1 months for ICDs and 4.7 ± 1.2 months for PMs; in 24% of ICDs the time interval between in-person visits was ≥18 months. Clinically relevant events were 56 (18 [4.4%] in ICDs, 38 [2.1%] in PMs), with no deaths and 21 serious malfunctions (4 [1%] in ICDs, 15 [0.8%] in PMs). RM identified all ICD malfunctions, while it was not available in the affected PMs. In comparison with the year 2019, serious malfunctions increased, though the difference was not significant. Monthly RM transmissions increased by 2.3 fold.
In our single-center experience during the COVID-19 pandemic, numerous in-person PM/ICD follow-up visits were postponed, and delays were well beyond the previously recommended time limits. However, device-related malfunctions did not increase, notably, when RM capabilities were used.
由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病疫情极大地改变了门诊随访方式。这项回顾性研究的目的是评估2020年疫情爆发期间，意大利拉韦纳和卢戈医院的中心对起搏器（PM）和植入式心脏复律除颤器（ICD）门诊随访进行重新安排的组织模式和临床效果。
纳入2020年3月至12月期间所有计划进行的面对面设备随访。根据每个设备过去记录的功能和远程监测（RM）能力，面对面随访在不同时间进行或推迟。分析随访的特征以及与设备相关的临床相关事件，后者进一步分为严重故障和需要通过设备重新编程纠正的问题。
总体而言，27%的面对面随访被推迟（n = 576）（ICD的36%和PM的25%），在2020年3月至5月达到峰值62%。RM弥补了几乎所有ICD的延误，而PM的延误仅弥补了63%。面对面随访之间因推迟导致的延迟，ICD为5.6±1.1个月，PM为4.7±1.2个月；24%的ICD面对面随访时间间隔≥18个月。临床相关事件有56起（ICD中18起[4.4%]，PM中38起[2.1%]），无死亡病例，严重故障21起（ICD中4起[1%]，PM中15起[0.8%]）。RM识别出了所有ICD故障，而受影响的PM中没有可用的RM。与2019年相比，严重故障有所增加，尽管差异不显著。每月RM传输量增加了2.3倍。
在我们单中心的2019冠状病毒病疫情期间的经验中，许多面对面的PM/ICD随访被推迟，延迟远远超出了先前推荐的时间限制。然而，尤其是在使用RM功能时，与设备相关的故障并未增加。
