Remote Management of Patients with Cardiac Implantable Electronic Devices during the COVID-19 Pandemic

Bettina Nagy; Ádám Pál-Jakab; Boldizsár Kiss; Gábor Orbán; Torda László Sélley; Zsigmond Dabasi-Halász; Barbara Bernadett Móka; László Gellér; Béla Merkely; Endre Zima

doi:10.3390/jcdd10050214

Remote Management of Patients with Cardiac Implantable Electronic Devices during the COVID-19 Pandemic

J Cardiovasc Dev Dis. 2023 May 14;10(5):214. doi: 10.3390/jcdd10050214.

Affiliations

¹ Heart and Vascular Centre, Faculty of Medicine, Semmelweis University, 1122 Budapest, Hungary.
² Biotronik Hungária Kft., 1124 Budapest, Hungary.

Abstract

Remote monitoring (RM) is the newest function of cardiac implantable electronic devices (CIEDs). In our observational retrospective analysis, we aimed to assess whether telecardiology could be a safe alternative to routine outpatient examinations during the COVID-19 pandemic. The in- and outpatient visits, the number of acute cardiac decompensation episodes, the RM data from CIEDs, and general condition were examined via questionnaires (KCCQ, EQ-5D-5L). Regarding the enrolled 85 patients, the number of personal patient appearances was significantly lower in the year following the pandemic outbreak compared to the previous year (1.4 ± 1.4 and 1.9 ± 1.2, p = 0.0077). The number of acute decompensation events was five before and seven during lockdown (p = 0.6). Based on the RM data, there was no significant difference in heart failure (HF) markers (all related p > 0.05); only patient activity increased after restrictions were lifted compared to that before the lockdown (p = 0.03). During restrictions, patients reported increased anxiety and depression compared to their previous state (p < 0.001). There was no subjective change in the perception of HF symptoms (p = 0.7). Based on the subjective perception and CIED data, the quality of life of patients with CIED did not deteriorate during the pandemic, but their anxiety and depression intensified. Telecardiology may be a safe alternative to routine inpatient examination.

Keywords: COVID-19; cardiac implantable electronic devices; chronic heart failure; remote monitoring.

Grants and funding

Open access funding is provided by Semmelweis University. B.M. reports grants from Boston Scientific, Medtronic and personal fees from Biotronik, Abbott, AstraZeneca, Boehringer Ingelheim, Novartis, outside the submitted work. L.G. reports grants from Medtronic and personal fees from Biotronik, Abbott, AstraZeneca, Boehringer Ingelheim, outside the submitted work. E.Z. reports lecture and advisory fees outside the submitted work from Biotronik, Medtronic, Boston Scientific, Zoll Medical, Novartis, Richter, Orion Pharma outside the submitted work. The study was supported by the MD-PhD Excellence Program of Semmelweis University (EFOP-3.6.3-VEKOP-16-2017-00009) and by grant EFOP-3.6.3-VEKOP-16-2017-00009 (“Semmelweis 250+ Excellence Scholarship”). Prepared with the professional support of the Doctoral Student Scholarship Program of the Co-operative Doctoral Program of the Ministry of Innovation and Technology financed from the National Research, Development and Innovation Fund (1014921). G.O. was supported by the MD-PhD Excellence Program of Semmelweis University (EFOP-3.6.3-VEKOP-16-2017-00009), by the ÚNKP-22-2-III-SE-59 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund, and by the National Academy of Scientist Education Program of the National Biomedical Foundation under the sponsorship of the Hungarian Ministry of Culture and Innovation (FEIF/646-4/2021- ITM_SZERZ). Project no. RRF-2.3.1-21-2022-00003 has been implemented with the support provided by the European Union.