Remote monitoring for heart failure management during COVID-19 pandemic

Bertagnin, Enrico; Greco, Antonio; Bottaro, Giuseppe; Zappulla, Paolo; Romanazzi, Imma; Russo, Maria Daniela; Presti, Marco Lo; Valenti, Noemi; Sollano, Giuseppe; Calvi, Valéria

doi:10.1016/j.ijcha.2021.100724

Cited by 23 publications

(25 citation statements)

References 29 publications

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“…In line with our study, there was also no significant change in resting heart rate, PP variability, CRT%, PVC frequency, and the occurrence of ventricular tachyarrhythmias or ICD shocks. 7 Very similar results were obtained by Bertagnin et al 8 huge number of patients retrospectively, using an RM platform and with limited medical information. In our opinion, the reasons for the lower physical activity reduction in BIO|STREAM.HF patients than in the previous studies are two-fold: different stringency and duration of home quarantine in different countries and the already limited baseline activity (mean 9.1%/day) in our CHF patients with NYHA class II-IV than in previous studies (10%−16%/day) that also included patients with less severe HF symptoms in whom more pronounced activity drop is possible during lockdown.…”

Section: Discussionsupporting

confidence: 73%

Impact of lockdown during COVID‐19 pandemic on physical activity and arrhythmia burden in heart failure patients

Schmitt

Wenzel

Brüsehaber

et al. 2022

Pacing Clinical Electrophis

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Background: Restricted outdoor activity during COVID-19 related lockdown may accelerate heart failure (HF) progression and thereby increase cardiac arrhythmias.We analyzed the impact of March/April 2020 lockdown on physical activity and arrhythmia burden in HF patients treated with cardiac resynchronization therapy (CRT) devices with daily, automatic remote monitoring (RM) function. Methods:The study cohort included 405 HF patients enrolled in Observation of Clinical Routine Care for Heart Failure Patients Implanted with BIOTRONIK CRT Devices (BIO|STREAM.HF) registry in 16 countries, who had left ventricular ejection fraction (LVEF) ≤40% (mean 28.2 ± 6.6%) and NYHA class II/III/IV (47.9%/49.6%/2.5%) before CRT pacemaker/defibrillator implantation. The analyzed RM data comprised physical activity detected by accelerometer, mean heart rate and nocturnal rate, PP variability, percentage of biventricular pacing, atrial high rate episode (AHRE) burden, ventricular extrasystoles and tachyarrhythmias, defibrillator shocks, and number of implant interrogations (i.e., follow-ups). Intraindividual differences in RM parameters before (4-week period) versus during (4-week period) lockdown were tested for statistical significance and independent predictors were identified.Results: There was a significant relative change in activity (mean −6.5%, p < .001), AHRE burden (+17%, p = .013), and follow-up rate (−75%, p < .001) during lockdown, with no significant changes in other RM parameters. Activity decreased by ≥8 min/day

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Section: Discussionsupporting

confidence: 73%

Impact of lockdown during COVID‐19 pandemic on physical activity and arrhythmia burden in heart failure patients

Schmitt

Wenzel

Brüsehaber

et al. 2022

Pacing Clinical Electrophis

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“…In the relatively large sample of 1,433 elderly patients with coronary vascular disease who were surveyed before and during the pandemic, an overall increase in moderate-to-vigorous PA (MVPA) was reported due to an increase in leisure time walking (van Bakel et al, 2021 ). In contrast, there are seven studies (relying on device-based measurement before and during the pandemic with smaller ad-hoc samples of patients with both severe and moderate heart disease) that indicate overall decrease in PA levels (Al Fagih et al, 2020 ; Browne et al, 2020 , 2021 ; Malanchini et al, 2020 ; Sassone et al, 2020 ; Vetrovsky et al, 2020 ; Bertagnin et al, 2021 ). Thus, even for groups with similar clinical diagnoses, results are heterogeneous, and even more so when different pathologies are considered.…”

Section: Resultsmentioning

confidence: 99%

Using COVID-19 Pandemic as a Prism: A Systematic Review of Methodological Approaches and the Quality of Empirical Studies on Physical Activity Behavior Change

Brand¹,

Nosrat²,

Späth³

et al. 2022

Front. Sports Act. Living

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BackgroundThe COVID-19 pandemic has highlighted the importance of scientific endeavors. The goal of this systematic review is to evaluate the quality of the research on physical activity (PA) behavior change and its potential to contribute to policy-making processes in the early days of COVID-19 related restrictions.MethodsWe conducted a systematic review of methodological quality of current research according to PRISMA guidelines using Pubmed and Web of Science, of articles on PA behavior change that were published within 365 days after COVID-19 was declared a pandemic by the World Health Organization (WHO). Items from the JBI checklist and the AXIS tool were used for additional risk of bias assessment. Evidence mapping is used for better visualization of the main results. Conclusions about the significance of published articles are based on hypotheses on PA behavior change in the light of the COVID-19 pandemic.ResultsAmong the 1,903 identified articles, there were 36% opinion pieces, 53% empirical studies, and 9% reviews. Of the 332 studies included in the systematic review, 213 used self-report measures to recollect prepandemic behavior in often small convenience samples. Most focused changes in PA volume, whereas changes in PA types were rarely measured. The majority had methodological reporting flaws. Few had very large samples with objective measures using repeated measure design (pre and during the pandemic). In addition to the expected decline in PA duration, these studies show that many of those who were active prepandemic, continued to be active during the pandemic.ConclusionsResearch responded quickly at the onset of the pandemic. However, most of the studies lacked robust methodology, and PA behavior change data lacked the accuracy needed to guide policy makers. To improve the field, we propose the implementation of longitudinal cohort studies by larger organizations such as WHO to ease access to data on PA behavior, and suggest those institutions set clear standards for this research. Researchers need to ensure a better fit between the measurement method and the construct being measured, and use both objective and subjective measures where appropriate to complement each other and provide a comprehensive picture of PA behavior.

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“…PA then recovered, increasing to the same level as found in the prelockdown period. In a similar study, Bertagnin et al [ 16 ] performed a week-to-week analysis including 211 patients, and found that PA decreased (–25.9%, P <.001) during the prelockdown period. Of note, patients’ perceptions about PA showed a very low correlation with remote monitoring–assessed PA levels ( R 2 =0.035, P =.04) [ 16 ].…”

Section: Discussionmentioning

confidence: 98%

Physical Activity in Patients With Heart Failure During and After COVID-19 Lockdown: Single-Center Observational Retrospective Study

Brasca¹,

Casale²,

Canevese³

et al. 2022

JMIR Cardio

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Background The COVID-19 pandemic forced several European governments to impose severe lockdown measures. The reduction of physical activity during the lockdown could have been deleterious. Objective The aim of this observational, retrospective study was to investigate the effect of the lockdown strategy on the physical activity burden and subsequent reassessment in a group of patients with heart failure who were followed by means of remote monitoring. Methods We analyzed remote monitoring transmissions during the 3-month period immediately preceding the lockdown, 69 days of lockdown, and 3-month period after the first lockdown in a cohort of patients with heart failure from a general hospital in Lombardy, Italy. We compared variation of daily physical activity measured by cardiac implantable electrical devices with clinical variables collected in a hospital database. Results We enrolled 41 patients with heart failure that sent 176 transmissions. Physical activity decreased during the lockdown period (mean 3.4, SD 1.9 vs mean 2.9, SD 1.8 hours/day; P<.001) but no significant difference was found when comparing the period preceding and following the lockdown (–0.0007 hours/day; P=.99). We found a significant correlation between physical activity reduction during and after the lockdown (R2=0.45, P<.001). The only significant predictor of exercise variation in the postlockdown period was the lockdown to prelockdown physical activity ratio. Conclusions An excessive reduction of exercise in patients with heart failure decreased the tolerance to exercise, especially in patients with more comorbidities. Remote monitoring demonstrated exercise reduction, suggesting its potential utility to encourage patients to maintain their usual physical activity levels.

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Remote monitoring for heart failure management during COVID-19 pandemic

Cited by 23 publications

References 29 publications

Impact of lockdown during COVID‐19 pandemic on physical activity and arrhythmia burden in heart failure patients

Impact of lockdown during COVID‐19 pandemic on physical activity and arrhythmia burden in heart failure patients

Using COVID-19 Pandemic as a Prism: A Systematic Review of Methodological Approaches and the Quality of Empirical Studies on Physical Activity Behavior Change

Physical Activity in Patients With Heart Failure During and After COVID-19 Lockdown: Single-Center Observational Retrospective Study

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