Tong Lin, Xiong Shiqiang, Hou Jun, Li Jin, Qin Shujuan, Zhang Yangchun, Yang Siqi, Qi Lingyao, Chen Xu, Luo Yan, Zhang Zhen, Deng Haoyu, Liu Hanxiong, Cai Lin
Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China.
Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Front Cardiovasc Med. 2022 May 9;9:864398. doi: 10.3389/fcvm.2022.864398. eCollection 2022.
Due to seriously imbalanced distribution of follow-up clinics in China, routine in-office visits are erratically attended by many cardiovascular implantable electronic device (CIED) patients. Meanwhile, remote monitoring is significantly underutilized. Novel tools to address the current predicament of routine in-office visits in China is urgently needed.
To assess the reliability and feasibility of cloud follow-up in CIED patients.
A total of 325 CIED patients from 13 hospitals in Sichuan Province, China, were enrolled. Information on patients' sociodemographic and basic clinical characteristics was collected. All devices were tested and programmed with 5G-cloud follow-up platform in a real-time manner. All patients were surveyed about their acceptance of and preferences regarding cloud follow-up compared to routine in-office visits.
Compliance with routine in-office visits in this region was 60.6%. None of the patients were enrolled in remote monitoring services. Clinically important predictors of non-compliance were elderly age (≥75 years old), odds ratio (OR) 2.392 (95% confidence interval, 1.111-5.150); needing notification from a follow-up clinic, OR 2.518 (1.179-5.376); and being beyond 15 months post-implantation, OR 5.440 (2.563-11.543). All cloud follow-up sessions were performed safely and efficiently, without any adverse events. 292 (89.8%) patients preferred cloud follow-up for future device management.
Compliance with routine in-office visits in this region has much room for improvement. Cloud follow-up addresses the limitations of an imbalanced distribution of follow-up clinics and geographic barriers for in-office CIED evaluation. Thus, cloud follow-up provides a potential solution to the current predicament of routine in-office visits in China.
由于中国随访门诊分布严重不均衡，许多心血管植入式电子设备（CIED）患者无法定期进行门诊随访。与此同时，远程监测的利用率也极低。迫切需要新的工具来解决中国目前门诊随访的困境。
评估CIED患者云随访的可靠性和可行性。
纳入了来自中国四川省13家医院的325例CIED患者。收集了患者的社会人口学和基本临床特征信息。所有设备均通过5G云随访平台进行实时测试和编程。与常规门诊随访相比，调查了所有患者对云随访的接受程度和偏好。
该地区常规门诊随访的依从率为60.6%。没有患者参加远程监测服务。不依从的重要临床预测因素包括老年（≥75岁），比值比（OR）为2.392（95%置信区间，1.111-5.150）；需要随访门诊通知，OR为2.518（1.179-5.376）；植入后超过15个月，OR为5.440（2.563-11.543）。所有云随访均安全、高效地进行，无任何不良事件。292例（89.8%）患者更倾向于未来通过云随访进行设备管理。
该地区常规门诊随访的依从性有很大的改善空间。云随访解决了随访门诊分布不均衡和CIED门诊评估地理障碍的局限性。因此，云随访为中国目前门诊随访的困境提供了一个潜在的解决方案。
