Cardiac implantable electronic devices replacements in patients followed by remote monitoring during COVID-19 lockdown

Abstract

Aims Following coronavirus disease (COVID-19) outbreak, the Italian government adopted strict rules of lockdown and social distancing. The aim of our study was to assess the admission rate for cardiac implantable electronic devices (CIEDs) replacement procedures in Campania, the 3rd-most-populous region of Italy, during COVID-19 lockdown. Methods and results Data were sourced from 16 referral hospitals in Campania from 10 March to 4 May 2020 (lockdown period) and during the same period in 2019. We retrospectively evaluated consecutive patients hospitalized for CIEDs replacement procedures during the two observational periods. The number and type of CIEDs replacement procedures among patients followed by remote monitoring (RM), the admission rate, and the type of hospital admission between the two observational periods were compared. In total, 270 consecutive patients were hospitalized for CIEDs replacement procedures over the two observation periods. Overall CIEDs replacement procedures showed a reduction rate of 41.2% during COVID-19 lockdown. Patients were equally distributed for sex (P = 0.581), and both age [median 76 years (IQR: 68–83) vs. 79 years (IQR: 68–83); P = 0.497]. Cardiac implantable electronic devices replacement procedures in patients followed by RM significantly increased (IR: +211%; P < 0.001), mainly driven by the remarkable increase rate trend of both PM (IR: +475%; P < 0.001) and implantable cardiac defibrillator replacement procedures (IR: +67%, P = 0.01), during COVID-19 lockdown compared with 2019 timeframe. Conclusions We showed a significant increase trend rate of replacement procedures among CIEDs patients followed by RM, suggesting the hypothesis of its increased use to closely monitoring and to optimize the hospital admission time during COVID-19 lockdown.

The Impact of the COVID-19 Outbreak on Patients’ Adherence to PCSK9 Inhibitors Therapy

“…Telemedicine proved to be a simple and well-tolerated tool for ensuring continuity of care and the outpatient management of patients with CV diseases during the COVID-19 pandemic [22,23]. Many telecommunication tools (e.g., live video conferencing, phone calls, remote monitoring of implanted or wearable devices) have been used to collect diagnostic and prognostic data when an in-hospital follow-up visit was not performed [22,24].…”

The Impact of COVID-19 Outbreak on Syncope Units Activities in Italy: A Report from the Italian Multidisciplinary Working Group on Syncope (GIMSI)

“…The remarkable increasing use of remote monitoring for the follow-up of CIEDs recipients and the increasing telemedicine follow-up visits for patients who experienced TLOC and related symptoms during the COVID-19 lockdown suggest that telehealth helped us to assure continuous care, reducing disease exposure for staff and physicians [12,13]. In this sense, telehealth may also represent a tool to be further used in the future [14,15]. The lack of an adequate reimbursement and the absence of sharing standards for CIEDs' remote monitoring or medical teleconsultation represent the most important reported barriers to the implementation of telehealth tools in the clinical practice [16].…”

The Impact of COVID-19 Pandemic on Hospitalization and Interventional Procedures for Cardiovascular Diseases during the First Wave in Italy

“…Several observational studies described the impact of the COVID-19 outbreak on cardiac pacing and electrophysiology activities during the first lockdown in Italy (Figure 1). [4,5], Veneto region [6], AIAC survey [7] and a multicentre study from Italian Syncope Units [8]. Each cell shows the percentage reduction in hospitalizations for a specific procedure compared to the pre-pandemic period, followed respectively by the absolute number of procedures in the pre-COVID 19 A retrospective multicenter study [4], carried out in Campania region, the most-populous region of Southern Italy with about 5.8 million residents, showed a significant reduction in the rate of all cardiac implantable electronic devices (CIEDs) implantations and in cardiac resynchronization therapy (CRT) and device replacements (p-value < 0.05), more likely because of the reduction in planned hospitalizations following Italian government measures to contain SARS-CoV-2 in-hospital diffusion.…”

“…No significant differences in both pacemaker (PM) and implantable cardiac defibrillator (ICD) replacement procedures (p-value 0.297 and 0.076, respectively) have been shown, more likely because of the increase in urgent unplanned hospitalizations. The increased use of remote monitoring (RM) to optimize the hospital admission time during COVID-19 lockdown for CIEDs recipients may explain these data [5,9].…”