In-hospital follow-up of implantable cardioverter defibrillator and pacemaker carriers: patients' inconvenience and points of view. A four-hospital Italian survey

Europace. 2012 Mar;14(3):345-50. doi: 10.1093/europace/eur334. Epub 2011 Nov 11.

Abstract

Aims: The increasing volume of pacemaker (PM) and implantable cardioverter defibrillator (ICD) implants and problems related to their functioning have highlighted the issue of device follow-ups. Patients' convenience regarding device visits has been little investigated. This work aims at surveying patients' efforts in attending the in-office PM/ICD follow-ups and at evaluating their expectations.

Methods and results: In four Italian referral centres, over a 3-month period, a 20-point questionnaire was completed by all consecutive patients at in-hospital PM/ICD visits. In total, 1109 questionnaire/patients were evaluated. Pacemakers were 68%, ICDs 16%, and cardiac resynchronizations (CRTs) (PM + ICD) 16%; 38% were females; mean age was 75 ± 11 years. Almost all were scheduled visits. There was frequent reprogramming and clinical examination, even after 6 months from implant. Perceived inconvenience for the in-office follow-up was relevant in 35% of cases; attitudes towards remote monitoring were positive in 88% of cases. Inter-group analysis showed some significant difference: PM patients were older and more frequently female; ICD carriers were younger, had the highest rate of clinical evaluation, a longer journey time, and the most positive opinion about remote follow-up. Cardiac resynchronization patients had a longer waiting time and the lowest inconvenience. Overall inconvenience was independently predicted by increasing age, lengthy travelling times, and being accompanied; favourable opinions about remote monitoring were predicted by overall inconvenience, and, in ICD carriers only, by lack of clinical examination.

Conclusions: Patients' perceptions of in-hospital PM/ICD visits were affected by age and by journey modalities. Individual factors seem to affect both opinions about in-office visits and expectations towards a possible remote follow-up.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Defibrillators, Implantable / psychology*
  • Female
  • Follow-Up Studies
  • Health Care Surveys
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Monitoring, Ambulatory / psychology
  • Office Visits
  • Pacemaker, Artificial / psychology*
  • Patient Satisfaction
  • Surveys and Questionnaires