Remote proctoring for cryoballoon ablation of atrial fibrillation: A challenge or an opportunity in the COVID-19 era?

Główniak, Andrzej; Petkanych, Myroslav; Wojewoda, Katarzyna; Komiaty, Vladimir; Sudol, Marcin; Dyomenko, Oksana; Torres, Kamil; Wysokiński, Andrzej; Sorgente, Antonio; Chierchia, Gian‐Battista; Asmundis, Carlo de

doi:10.5603/cj.a2021.0100

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Since 2015, our centre's expert electrophysiologists have served as proctors, teaching operators from other centres how to perform invasive treatment of atrial fibrillation with cryoballoon ablation (CBA). With the onset of the pandemic, we faced a vital decision—whether to postpone scheduled CBA proctoring in a regional centre in Ukraine, with all its consequences, or to continue with a new, remote‐based approach 1 …”

Section: What Problems Were Addressed?mentioning

confidence: 99%

Remote‐presence approach to cryoablation training: Beyond COVID‐19

Główniak¹,

Petkanych²,

Torres³

et al. 2023

Medical Education

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course knowledge of genetics and genomics of residents was assessed using 50 pre-validated multiple-choice questions (MCQs).Finally, Likert-scale surveys evaluated residents' attitudes, knowledge and ethical perceptions toward PM and satisfaction with the course. | WHAT LESSONS WERE LEARNED?Twenty (71%) residents completed all three levels of the assessment and evaluation. Residents' knowledge assessment showed a learning gain of 48% in pre-post MCQs upon completion. Learners showed positive attitudes toward the adoption of PM. About 83% of respondents agreed to be willing to use a patient's genetic information in clinical practice. Very few (9%) were confident to use PM-based approaches; moreover, 43% of respondents agreed that disclosure of genetic information could lead to discrimination and social stigma.Residents were satisfied with the course of PM (95%), but the major challenge was accessing Moodle (45%). Conclusively, we learned that involving various stakeholders, scheduling and planning are essential for project implementation success, considering residents' busy routines. We also noticed that it is a mandatory pre-requisite to provide knowledge of basic genomic concepts for a better understanding of PM. Lastly, multiple communication channels should be developed for reminders of teaching and assessment sessions. AUTHOR CONTRIBUTIONSRichard Nduwayezu: Review and editing (equal). Joseph Lune Ngenzi:Review and editing (equal). Usman Mahboob: Conceptualization (supporting), writing-original draft (supporting); formal analysis (supporting); writing-review and editing (equal); Methodology (supporting). Annette Uwineza: Conceptualization (lead), writing-original draft (lead); formal analysis (lead); writing-review and editing; Methodology (lead); review and editing (equal).

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Section: What Problems Were Addressed?mentioning

confidence: 99%

Remote‐presence approach to cryoablation training: Beyond COVID‐19

Główniak¹,

Petkanych²,

Torres³

et al. 2023

Medical Education

Self Cite

View full text Add to dashboard Cite

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Remote proctoring during structural heart procedures: Toward a widespread diffusion of knowledge using mixed reality

Ascione,

Rossini,

Schiavi

et al. 2024

Cathet Cardio Intervent

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BackgroundDespite its wide diffusion in surgical procedures, very few experiences are reported so far about the possible applications of remote proctoring (RP) in structural heart interventions.AimsOur aim was to demonstrate the feasibility, safety, and efficacy of RP during transcatheter edge‐to‐edge repair using a mixed reality‐based head‐mounted display (HMD).MethodsTwo users (a doctor and a proctor), wearing HMDs, were connected through a 5G network, allowing them to share audio and video signals. During the procedure, the proctor was located in a contiguous room, without any direct connection with the operator. The primary endpoint was noninferiority of HMD‐mediated interaction if compared with direct in‐person interaction. It was assessed using an operator−proctor interaction test based on six questions asked by the doctor to the proctor on six key procedural steps.ResultsBetween September 2021 and April 2022, nine patients were enrolled in the study (15 clips delivered). The primary endpoint was reached in 9/15 clips implanted (60%). The first three failures were due to a chat software problem, and the others were linked with a 5G network malfunction. However, the HMD and its mixed reality tools were well tolerated by the operators, and no interference with the procedure was registered in any of the cases.ConclusionsIn our experience, RP during structural heart interventions is feasible and efficacious. Wearing the HMD is comfortable and does not affect safety and effectiveness of interventional procedures. However, especially if considering a wide geographic use of this tool, a stable internet connection is imperative.

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Teleproctoring for Training in Structural Heart Interventions: Initial Real‐World Experience During the COVID‐19 Pandemic

Beyhoff

Zhu

Zanders

et al. 2022

JAHA

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Background Proctoring represents a cornerstone in the acquisition of state‐of‐the‐art cardiovascular interventions. Yet, travel restrictions and containment measures during the COVID‐19 pandemic limited on‐site proctoring for training and expert support in interventional cardiology. Methods and Results We established a teleproctoring setup for training in a novel patent foramen ovale closure device system (NobleStitch EL, HeartStitch Inc, Fountain Valley, CA) at our institution using web‐based real‐time bidirectional audiovisual communication. A total of 6 patients with prior paradoxical embolic stroke and a right‐to‐left shunt of grade 2 or 3 were treated under remote proctorship after 3 cases were performed successfully under on‐site proctorship. No major device/procedure‐related adverse events occurred, and none of the patients had a residual right‐to‐left shunt of grade 1 or higher after the procedure. Additionally, we sought to provide an overview of current evidence available for teleproctoring in interventional cardiology. Literature review was performed identifying 6 previous reports on teleproctoring for cardiovascular interventions, most of which were related to the current COVID‐19 pandemic. In all reports, teleproctoring was carried out in similar settings with comparable setups; no major adverse events were reported. Conclusions Teleproctoring may represent a feasible and safe tool for location‐independent and cost‐effective training in a novel patent foramen ovale closure device system. Future prospective trials comparing teleproctoring with traditional on‐site proctoring are warranted.

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Remote proctoring for cryoballoon ablation of atrial fibrillation: A challenge or an opportunity in the COVID-19 era?

Abstract: This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Cardiology Journal" are listed in PubMed.

Cited by 3 publications

References 10 publications

Remote‐presence approach to cryoablation training: Beyond COVID‐19

Remote‐presence approach to cryoablation training: Beyond COVID‐19

Remote proctoring during structural heart procedures: Toward a widespread diffusion of knowledge using mixed reality

Teleproctoring for Training in Structural Heart Interventions: Initial Real‐World Experience During the COVID‐19 Pandemic

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