Ploux Sylvain, Strik Marc, Abu-Alrub Saer, Ramirez F Daniel, Buliard Samuel, Marchand Hugo, Picard François, Eschalier Romain, Haïssaguerre Michel, Bordachar Pierre
Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Electrophysiology and Pacing Department, F-33600 Pessac, France.
IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France.
Eur Heart J Digit Health. 2021 Apr 29;2(3):487-493. doi: 10.1093/ehjdh/ztab044. eCollection 2021 Sep.
Multiparametric remote monitoring of patients with heart failure (HF) has the potential to mitigate the health risks of lockdowns for COVID-19. We aimed to compare healthcare use, physiological variables, and HF decompensations during 1 month before and during the first month of the first French national lockdown for COVID-19 among patients undergoing remote monitoring.
Transmitted vital parameters and data from cardiac implantable electronic devices were analysed in 51 patients. Medical contact was defined as the sum of visits and days of hospitalization. The lockdown was associated with a marked decrease in cardiology medical contact (118 days before vs. 26 days during, -77%, = 0.003) and overall medical contact (180 days before vs. 79 days during, -58%, = 0.005). Patient adherence with remote monitoring was 84 ± 21% before and 87 ± 19% during lockdown. The lockdown was not associated with significant changes in various parameters, including physical activity (2 ± 1 to 2 ± 1 h/day), weight (83 ± 16 to 83 ± 16 kg), systolic blood pressure (121 ± 19 to 121 ± 18 mmHg), heart rate (68 ± 10 to 67 ± 10 b.p.m.), heart rate variability (89 ± 44 to 78 ± 46 ms, = 0.05), atrial fibrillation burden (84 ± 146 vs. 86 ± 146 h/month), or thoracic impedance (66 ± 8 to 66 ± 9 Ω). Seven cases of HF decompensations were observed before lockdown, all but one of which required hospitalization, vs. six during lockdown, all but one of which were managed remotely.
The lockdown restrictions caused a marked decrease in healthcare use but no significant change in the clinical status of HF patients under multiparametric remote monitoring.
对心力衰竭（HF）患者进行多参数远程监测有可能降低因新冠疫情封锁措施而带来的健康风险。我们旨在比较在法国首次因新冠疫情实施全国封锁的前1个月及封锁第1个月期间，接受远程监测的患者的医疗保健利用情况、生理变量和心力衰竭失代偿情况。
分析了51例患者传输的重要参数和心脏植入式电子设备的数据。医疗接触定义为就诊次数和住院天数之和。封锁与心脏病医疗接触显著减少相关（封锁前118天 vs. 封锁期间26天，-77%，P = 0.003）以及总体医疗接触显著减少相关（封锁前180天 vs. 封锁期间79天，-58%，P = 0.005）。患者在封锁前对远程监测的依从性为84±21%，封锁期间为87±19%。封锁与各种参数的显著变化无关，包括身体活动（2±1至2±1小时/天）、体重（83±16至83±16千克）、收缩压（121±19至121±18毫米汞柱）、心率（68±10至67±10次/分钟）、心率变异性（89±44至78±46毫秒，P = 0.05）、房颤负荷（84±146 vs. 86±146小时/月）或胸部阻抗（66±8至66±9欧姆）。封锁前观察到7例心力衰竭失代偿病例，除1例之外均需住院治疗，而封锁期间观察到6例，除1例之外均通过远程管理。
封锁限制导致医疗保健利用显著减少，但在多参数远程监测下，心力衰竭患者的临床状况没有显著变化。
