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Reorganizing the device clinic: remote monitoring of cardiac implantable electronic devices during the COVID-19 pandemic
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  • Elisa Ebrille,
  • Claudia Amellone,
  • Maria Teresa Lucciola,
  • Marco Suppo,
  • Giuseppe Antonacci,
  • Franco Gotta,
  • Marco Birolo,
  • Fabrizio Orlando,
  • Elisa Favro,
  • Massimo Giammaria
Elisa Ebrille
Maria Vittoria Hospital

Corresponding Author:[email protected]

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Claudia Amellone
Maria Vittoria Hospital
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Maria Teresa Lucciola
Maria Vittoria Hospital
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Marco Suppo
Maria Vittoria Hospital
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Giuseppe Antonacci
Maria Vittoria Hospital
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Franco Gotta
Maria Vittoria Hospital
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Marco Birolo
Maria Vittoria Hospital
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Fabrizio Orlando
Maria Vittoria Hospital
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Elisa Favro
Maria Vittoria Hospital
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Massimo Giammaria
Maria Vittoria Hospital
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Abstract

COVID-19 pandemic has caused a necessary reorganization of the elective outpatient device clinic. Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) has been validated as a safe and effective tool to follow patients, limiting the need for in-person visits. We provided a snapshot of the current clinical practice in a tertiary electrophysiology center in Italy, suggesting a potential model of care for patients with CIEDs. Before the COVID-19 pandemic, patients with implantable cardioverter defibrillators/cardiac resynchronization therapy (ICD/CRTs) were evaluated in the device clinic twice a year and patients with pacemakers (PMs) once a year; loop recorder (ILR) patients were followed remotely only. In the COVID-19 period RM was implemented for all compatible CIEDs. Patients with RM were not seen in clinic anymore and were followed with RM. In the COVID-19 period, 100% of newly implanted devices received RM (82 ILR, 194 PMs, 80 ICDs/CRTs), compared to 68% in the same months of 2019 (106/106 ILR, 83/203 PMs, 78/82 ICD/CRTs), p<0.01. Moreover, 502 previously implanted patients with RM compatible devices were contacted and received RM. By the end of February 2021, 1676 patients were remotely monitored at our Institution, with a potential saving of outpatient visits of 1683 visits/year, against an average of 8514 RM transmissions/year needing evaluation. RM of CIEDs is essential to reduce in-person visits during the COVID-19 pandemic. The potential for elective outpatient appointments reduction has to be counterbalanced by the sustainability of a large number of transmissions and data to analyze.