Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo, 71, 41124 Modena, Italy.
EHRA mHEALTH and Health Economics Section, European Heart Rhythm Association.
Europace. 2022 Dec 9;24(12):1875-1880. doi: 10.1093/europace/euac118.
Remote monitoring (RM) of cardiac implantable electrical devices (CIEDs) is currently proposed as a standard of care for CIEDs follow-up, as recommended by major cardiology societies worldwide. By detecting a series of relevant device and patient-related parameters, RM is a valuable option for early detection of CIEDs' technical issues, as well as changes in parameters related to cardio-respiratory functions. Moreover, RM may allow longer spacing between in-office follow-ups and better organization of in-hospital resources. Despite these potential advantages, resulting in improved patient safety, we are still far from a widespread diffusion of RM across Europe. Reimbursement policies across Europe still show an important heterogeneity and have been considered as an important barrier to full implementation of RM as a standard for the follow-up of all the patients with pacemakers, defibrillators, devices for cardiac resynchronization, or implantable loop recorders. Indeed, in many countries, there are still inertia and unresponsiveness to the request for widespread implementation of RM for CIEDs, although an improvement was found in some countries as compared to years ago, related to the provision of some form of reimbursement. As a matter of fact, the COVID-19 pandemic has promoted an increased use of digital health for connecting physicians to patients, even if digital literacy may be a limit for the widespread implementation of telemedicine. CIEDs have the advantage of making possible RM with an already defined organization and reliable systems for data transmissions that can be easily implemented as a standard of care for present and future cardiology practice.
远程监测(RM)目前被提议作为心脏植入式电子设备(CIED)随访的标准护理,这是全球主要心脏病学会推荐的。通过检测一系列相关的设备和患者相关参数,RM 是早期发现 CIED 技术问题以及与心肺功能相关参数变化的有价值的选择。此外,RM 可能允许在办公室随访之间有更长的间隔时间,并更好地组织医院资源。尽管有这些潜在的优势,提高了患者的安全性,但我们离 RM 在欧洲的广泛传播还有很长的路要走。欧洲各地的报销政策仍然存在很大的差异,被认为是全面实施 RM 作为起搏器、除颤器、心脏再同步设备或植入式环路记录器患者随访标准的一个重要障碍。事实上,尽管与多年前相比,一些国家在为 RM 的广泛实施提供某种形式的报销方面有所改善,但在许多国家,对广泛实施 RM 仍存在惰性和不响应。事实上,COVID-19 大流行推动了数字健康在连接医生和患者方面的更多使用,尽管数字素养可能是远程医疗广泛实施的一个限制。CIED 的优点是可以通过已经定义的组织和可靠的数据传输系统进行 RM,这些系统可以很容易地作为当前和未来心脏病学实践的标准护理实施。