Borrelli Nunzia, Grimaldi Nicola, Fusco Flavia, Orlando Antonio, Palma Michela, Boccia Maria Cristina, Bassolino Sabrina, Iervolino Anna, Sarubbi Berardo
Adult Congenital Heart Disease and Congenital and Familial Arrhythmias Unit, Monaldi Hospital, Naples, Italy.
Medical Direction Unit, Monaldi Hospital, Naples, Italy.
Int J Cardiol Congenit Heart Dis. 2025 Apr 7;20:100582. doi: 10.1016/j.ijcchd.2025.100582. eCollection 2025 Jun.
The number of adults with congenital heart disease has significantly increased in recent years. While telemedicine has emerged as a promising approach to improve care delivery and patient outcomes, its use for adults with congenital cardiopathies has not been extensively explored. This study aims to evaluate the feasibility and clinical impact of a telemedicine programme for adults with congenital heart diseases.
This was a single-center, prospective, observational study, carried out between January 2022 and January 2023. A wristwatch, a paired mobile device, and a dedicated hospital workstation were used to telemonitor 25 adult patients with moderate-to-severe congenital heart condition, in II-IV New-York Heart Association class. We assessed changes in hospital admission days and related costs, patient satisfaction, and functional parameters, including 6-min walk test distance, vital signs, and echocardiographic ejection fraction.
All 25 patients agreed to participate to the telemedicine program (mean age 38.35 ± 11.33 years, 52 % male). Twenty-three patients completed the program. No significant changes were observed in vital signs, functional class, ventricular ejection fraction, while walking distance significantly improved (404 ± 82 m versus 433 ± 142 m, p = 0.03). Notably, hospital admission days and related costs were significantly reduced during the TM program year compared to the prior year. Patient satisfaction was high. One patient experienced a prolonged hospitalization and death due to the natural progression of their condition.
High-risk patients with moderate-severe congenital heart disease can benefit from a device-implemented telemedicine program, which offers tailored, specialized care directly at home, reducing hospital admissions and ensuring stable clinical status.
近年来，患有先天性心脏病的成年人数量显著增加。虽然远程医疗已成为改善医疗服务和患者预后的一种有前景的方法，但其在先天性心脏病成年患者中的应用尚未得到广泛探索。本研究旨在评估针对先天性心脏病成年患者的远程医疗项目的可行性和临床影响。
这是一项单中心、前瞻性观察性研究，于2022年1月至2023年1月进行。使用一块手表、一台配对的移动设备和一个专用的医院工作站对25名患有中度至重度先天性心脏病、纽约心脏协会心功能分级为II-IV级的成年患者进行远程监测。我们评估了住院天数和相关费用的变化、患者满意度以及功能参数，包括6分钟步行试验距离、生命体征和超声心动图射血分数。
所有25名患者均同意参与远程医疗项目（平均年龄38.35±11.33岁，52%为男性）。23名患者完成了该项目。生命体征、心功能分级、心室射血分数未观察到显著变化，而步行距离显著改善（404±82米对433±142米，p=0.03）。值得注意的是，与上一年相比，在远程医疗项目年度，住院天数和相关费用显著减少。患者满意度较高。一名患者因病情自然进展经历了延长住院和死亡。
患有中度至重度先天性心脏病的高危患者可从设备实施的远程医疗项目中获益，该项目直接在家中提供量身定制的专科护理，减少住院次数并确保临床状态稳定。
