Creation of pacemaker remote monitoring networks between hospital and pharmacies during Covid-19 outbreak. 2023

Donato Melissano, and Maria Rosaria Gualtieri, and Assunta Greco, and Antonella Muscella, and Antonio Marzo, and Claudio Perrone
Presidio Ospedaliero "Francesco Ferrari", Dipartimento Cardiovascolare, U.O.S.V.D, Cardiologia, Viale Francesco Ferrari, 1, 73042, Casarano, Lecce, Italy. Electronic address: donato.melissano.53@gmail.com.

BACKGROUND Remote Monitoring (RM) of Cardiac Implantable Electronic Devices (CIEDs) is proven to be safe and efficient. It has been adopted in our center since years. At the time of the recent Covid-19 outbreak, we introduced and tested a collaborative organizational model, through a new RM device (Totem), creating a network with the surrounding territory and limiting CIED patients' presence in hospital. METHODS We involved 4 neighbor pharmacies where Totem devices were installed; we called and informed 64 patients with Totem compatible pacemaker (PM) about the possibility to perform their PM follow-up (FU) in-pharmacy; 58 gave their consent and their data were inserted into our RM database. RESULTS During an 18-month FU period, a total of 70 RM transmissions have been received: one alert of high atrial burden triggering a pharmacological optimization, one alert of high ventricular impedance leading to a new ventricular lead implantation and four alerts of elective replacement indicator. Fulfilled questionnaires revealed complete patient satisfaction. CONCLUSIONS A collaborative network between our hospital and the surrounding territory to perform RM FUs of CIEDs during Covid-19 pandemic was feasible, leading to patient compliance and satisfaction and revealing important technical and clinical alerts.

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