Takami Mitsuru, Fukuzawa Koji, Kiuchi Kunihiko, Takahara Hiroyuki, Imamura Kimitake, Nakamura Toshihiro, Sonoda Yusuke, Nakasone Kazutaka, Yamamoto Kyoko, Suzuki Yuya, Tani Kenichi, Iwai Hidehiro, Nakanishi Yusuke, Shoda Mitsuhiko, Murakami Atsushi, Yonehara Shogo, Hirata Ken-Ichi
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine Kobe Japan.
Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine Kobe Japan.
Circ Rep. 2023 Oct 28;5(11):415-423. doi: 10.1253/circrep.CR-23-0083. eCollection 2023 Nov 10.
There is a strong demand for remote monitoring systems to gather health data. This study investigated the safety, usefulness, and patient satisfaction in outpatient care using telehealth with real-time electrocardiogram (ECG) monitoring after catheter ablation. In all, 38 patients who underwent catheter ablation were followed up using telehealth. At the 3- and 6-month follow-up, a self-fitted Duranta ECG monitoring device was sent to the patient's home before the online consultation. Patients attached the devices themselves, and the doctors viewed the patients by video chat and performed real-time ECG monitoring. The frequency of hospital visits and the ECG monitoring duration were compared with conventional in-person follow-up data (n=102). The completion rate for telehealth follow-up was 32 of 38 patients (84%). The number of hospital visits during the 6 months was significantly lower with telehealth follow-up than with conventional follow-up (median [interquartile range] 1 [1-1] vs. 5 [3-5]; P<0.0001). However, the ECG monitoring duration was approximately 4-fold longer for the telehealth follow-up (median [interquartile range] 89 [64-117] vs. 24 [0.1-24] h; P<0.0001). No major adverse events were observed during the telehealth follow-up. Patient surveys showed high satisfaction with telehealth follow-up due to reduced hospital visits. A combination of telehealth follow-up with real-time ECG monitoring increased the ECG monitoring duration and patient satisfaction without any adverse events.
对收集健康数据的远程监测系统有强烈需求。本研究调查了在导管消融术后使用远程医疗进行实时心电图(ECG)监测的门诊护理中的安全性、实用性和患者满意度。总共38例接受导管消融术的患者通过远程医疗进行随访。在3个月和6个月随访时,在在线咨询前将自行佩戴的Duranta ECG监测设备送到患者家中。患者自行佩戴设备,医生通过视频聊天查看患者并进行实时ECG监测。将就诊频率和ECG监测时长与传统的面对面随访数据(n = 102)进行比较。远程医疗随访的完成率为38例患者中的32例(84%)。远程医疗随访6个月期间的就诊次数显著低于传统随访(中位数[四分位间距]1[1 - 1]对5[3 - 5];P < 0.0001)。然而,远程医疗随访的ECG监测时长约为传统随访的4倍(中位数[四分位间距]89[64 - 117]对24[0.1 - 24]小时;P < 0.0001)。在远程医疗随访期间未观察到重大不良事件。患者调查显示,由于就诊次数减少,对远程医疗随访满意度较高。远程医疗随访与实时ECG监测相结合增加了ECG监测时长和患者满意度,且无任何不良事件。