Impact of remote monitoring in heart failure patients with cardiac implantable electronic devices during COVID-19 pandemic: a single center experience

• Published in: Journal of cardiothoracic surgery Vol. 17; no. 1; pp. 213 - 9
• Main Authors: Ezer, Péter, Gergics, Marin, Szokodi, István, Kónyi, Attila
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 28-08-2022; BioMed Central; BMC
• Subjects: Algorithms; Arrhythmia; Cardiac arrhythmia; Cardiac Resynchronization Therapy; Comparative analysis; Congestive heart failure; Coronaviruses; COVID-19; Defibrillators, Implantable; Disease transmission; Electronic devices; Electronic equipment; Electronics; Epidemics; Ethics; Failure detection; Follow-up; Health care; Health care industry; Heart Failure; Heart rate; Humans; Medical equipment; Medical personnel; Observational studies; Pandemics; Patients; Physiological apparatus; Preempting; Prevention; Remote monitoring; Statistical analysis; Survival analysis; Telemedicine; Viral diseases; Workflow; COVID-19; Heart failure; Remote monitoring; Follow-up
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/s13019-022-01963-y

Coronavirus disease 2019 (COVID-19) had spread into a pandemic affecting healthcare providers worldwide. Heart failure patients with implanted cardiac devices require close follow-up in-spite of pandemic related healthcare restrictions.
Patients were retrospectively registered and clinical outcomes were compared of 61 remote monitored (RMG) versus 71 conventionally (in-office only) followed (CFG) cardiac device implanted, heart failure patients. Follow-up length was 12 months, during the COVID-19 pandemic related intermittent insitutional restrictions. We used a specified heart failure detection algorithm in RMG. This investigation compared worsening heart failure-, arrhythmia- and device related adverse events as primary outcome and heart failure hospitalization rates as secondary outcome in the two patient groups.
No significant difference was observed in the primary composite end-point during the first 12 months of COVID-19 pandemic (p = 0.672). In RMG, patients who had worsening heart failure event had relative modest deterioration in heart failure functional class (p = 0.026), relative lower elevation of N terminal-pro BNP levels (p < 0.01) at in-office evaluation and were less hospitalized for worsening heart failure in the first 6 months of pandemic (p = 0.012) compared to CFG patients.
Specified remote monitoring alert-based detection algorithm and workflow in device implanted heart failure patients may potentially indicate early worsening in heart failure status. Preemptive adequate intervention may prevent further progression of deteriorating heart failure and thus prevent heart failure hospitalizations.