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Management of Cardiac Implantable Electronic Device Follow-Up in COVID-19 Pandemic: Lessons Learnt During Italian Lockdown
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  • Agostino Piro,
  • Michele Magnocavallo,
  • Domenico Della Rocca,
  • Giovanna Manzi,
  • Matteo Neccia,
  • Alessia Bernardini,
  • Marco Valerio Mariani,
  • Martina Straito,
  • Paolo Severino,
  • Giuseppe Giunta,
  • Gino Iannucci,
  • Cristina Chimenti,
  • Andrea Natale,
  • Francesco Fedele,
  • Carlo Lavalle
Agostino Piro
Sapienza University of Rome
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Michele Magnocavallo
Sapienza University of Rome
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Domenico Della Rocca
Texas Cardiac Arrhythmia Institute
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Giovanna Manzi
Sapienza University of Rome
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Matteo Neccia
Sapienza University of Rome
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Alessia Bernardini
Sapienza University of Rome
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Marco Valerio Mariani
Sapienza University of Rome
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Martina Straito
Sapienza University of Rome
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Paolo Severino
Sapienza University of Rome
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Giuseppe Giunta
Sapienza University of Rome
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Gino Iannucci
Sapienza University of Rome
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Cristina Chimenti
Sapienza University of Rome
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Andrea Natale
St. David's Medical Center
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Francesco Fedele
Sapienza University of Rome
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Carlo Lavalle
Sapienza University of Rome
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Peer review status:IN REVISION

22 Jun 2020Submitted to Journal of Cardiovascular Electrophysiology
23 Jun 2020Assigned to Editor
23 Jun 2020Submission Checks Completed
25 Jun 2020Reviewer(s) Assigned
08 Jul 2020Review(s) Completed, Editorial Evaluation Pending
11 Jul 2020Editorial Decision: Revise Minor

Abstract

Introduction: Remote monitoring (RM) has profoundly transformed the standard of care for patients with cardiac electronic implantable devices. It provides easy access to valuable information about arrhythmic events, acute decompensation manifestations and device-related issues without the need of continuous in-person visits. Methods: Starting March 1st, 332 patients were introduced to a RM program during the Italian lockdown in order to limit the risk of in-hospital exposure to Severe Acute Respiratory Syndrome Coronavirus-2. Patients were categorized in two groups based on the modality of RM delivery [home (n=229) vs office (n= 103) delivered]. The study aimed at assessing the efficacy of the new follow-up protocol, reported as the mean RM Activation Time (AT) and the need for technical support for its activation. Patients’ acceptance and anxiety status was also quantified by means of the Home Monitoring Acceptance and Satisfaction Questionnaire and the Generalized Anxiety Disorder 7-item scale. Results: AT time was <48 hours in 93% of patients and 7% of them required further technical support. Despite a higher number of trans-telephonic technical support in home-delivered RM group, AT was comparable between groups (1.33±0.83 days in home-delivered vs 1.28±0.81 days in office-delivered patients; p=0.60). Twenty-eight (2.5%) urgent/emergent in-person examinations were planned. High degree of patient’s satisfaction was reached in both groups while anxiety status was higher in office-delivered group. Conclusions: RM was effective, safe and well tolerated by patients during the Italian lockdown. Our findings confirm the efficacy of this approach to reduce in-hospital visits, guaranteeing patients’ safety and quality of care.