scholarly journals Impact of the COVID-19 pandemic on electrophysiological procedures at a national referral center

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A Cueva-Parra ◽  
G Munoz-Benavides ◽  
W Ortiz-Solis ◽  
J Gomez-Flores ◽  
MF Marquez ◽  
...  
Keyword(s):  
Electronic Devices ◽  
Referral Center ◽  
Funding Sources ◽  
Cardiac Implantable Electronic Devices ◽  
Electrophysiological Studies ◽  
Electrophysiological Procedures ◽  
The Impact ◽  
Large Groups ◽  
Made In ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Background - Introduction: The COVID-19 pandemic has generated serious repercussions on the health system, reducing the number of all cardiology procedures worldwide. Objectives Describe the impact of the COVID-19 pandemic on the procedures performed by the electrophysiology department in a national referral center.  Methods We made a retrospective review of our data base and we compared procedures made in the last 3 years since 2017 to 2019 with the procedures made in the 2020. We divide the procedures into two large groups: Cardiac Implantable Electronic Devices (CIED) related procedures (which included implants, revisions, changes, upgrades and extractions) and electrophysiological studies and ablations (which included conventional and complex procedures). Other types of procedures were no included. Results There was a significant reduction in all procedures, the average of procedures performed in the last 3 previous years was 467 (there were 479 in 2017, 411 in 2018 and 511 in 2019), while in 2020 we performed only 319 (p = 0.01); this represents a reduction of 33.4% in the total number of procedures performed in our center. There was no statistical difference regarding the CIED related procedures, the average of procedures of the last 3 previous years was 174 (there were 186 in 2017, 148 in 2018 and 188 in 2019), and in 2020 we performed 189 procedures, this value is near to the average of the last 3 previous years and very close to the value of the 2019 (p = 0.46). Regarding the electrophysiological studies and ablations, the average of procedures of the last 3 previous years was 293 (there were 293 in 2017, 263 in 2018 and 323 in 2019), while in 2020 we performed only 129 procedures, considerably decreasing compared to the previous years (p < 0.01). The reduction in the electrophysiological studies and ablations was 55.97%. The most affected months were April, May and June. Conclusions The COVID-19 pandemic considerably affected the number of electrophysiological procedures in our center, reducing it by 33.4% compared to the previous years. The reduction of procedures fundamentally affected the electrophysiological studies and ablations, reducing them by 55.97%. The number of CIED related procedures were no affected. Electrophysiological procedures Procedures2017201820192017-2019 average2020CIED related procedures186148188174189Electrophysiological studies and ablations293263323293129Total479411511467319Comparative table of the electrophysiological procedures performed in our center in recent years.Abstract Figure. Comparison of the procedures.

scholarly journals Last before-death transmission in patients with heart failure and implantable cardioverter-defibrillator followed by remote monitoring - insights from the COMMIT-HF registry

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
M Dyrbus ◽  
M Tajstra ◽  
L Pyka ◽  
A Kurek ◽  
M Gasior
Keyword(s):  
Heart Failure ◽  
Remote Monitoring ◽  
Hospital Admissions ◽  
Biventricular Pacing ◽  
Electronic Devices ◽  
Funding Sources ◽  
Cardiac Implantable Electronic Devices ◽  
Patients With Heart Failure ◽  
Median Period ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Background  Remote monitoring (RM) of cardiac implantable electronic devices (CIED) in patients with heart failure allows to regularly analyze the devices" and patients" conditions.  Purpose  The purpose of this study was evaluation of the ultimate transmissions sent before death in patients monitored remotely.  Methods  The last transmissions delivered by the devices in patients enrolled into COMMIT-HF Registry (NCT02536443) who died when monitored remotely have been retrospectively analysed. The characteristics and contents of the transmissions and clinical reactions undertaken have been obtained from the RM systems of four major RM providers.  Results  Of 1,306 patients with CIEDs who were enrolled at the RM programme in our centre, 267 died and their last transmission occurred less than 90 days before death, of which 133 (49.8%) were scheduled and 134 (50.2%) alert-triggered. The median period between transmission and death was 31 days for scheduled and 8 days for alert-triggered transmissions. The most frequent alert-triggered transmissions were atrial fibrillation/flutter (35.8%) and ventricular tachyarrhythmias (24.6%). A clinical reaction has been undertaken after 9.8% of planned and 67.1% of alert-triggered transmissions and consisted mainly of telephone consultations and referrals for hospital admissions.  Conclusions  This is the first analysis of the ultimate transmissions delivered by CIEDs before death. In approximately 50% of patients, the last transmission has been alert-triggered. Hence, an appropriate organization of the RM facility, which should immediately analyse and react to the transmission, seems mandatory to obtain clinical benefit in patients with HF and RM. Causes of alerts and clinical reactionsCause of alertAll alert-triggered transmissions (N = 134)AF/AFL episode, n (%)48 (35.8%)Ventricular tachycardia, n (%)18 (13.4%)Ventricular fibrillation, n (%)15 (11.2%)Biventricular pacing percentage reduction, n (%)15 (11.2%)Others38 (28.3%)Congestion monitor indications, n (%)14 (10.4%)Clinical reactionPlanned transmission (N = 133)Alert-triggered transmission (N = 134)Telephone consultation10 (7.5%)58 (43.2%)Referral to the GP or outpatient specialist clinic visit2 (1.5%)12 (8.9%)Referral for hospital admission1 (0.7%)18 (13.4%)Pharmacotherapy modificationN/A2 (1.5%)Abstract Figure.

The underrepresentation of female participants in studies assessing the impact of high-dose exercise on cardiovascular outcomes: a scoping review

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
S Pallikadavath ◽  
R Patel ◽  
CL Kemp ◽  
M Hafejee ◽  
N Peckham ◽  
...  
Keyword(s):  
Scoping Review ◽  
High Volume ◽  
Cardiovascular Outcomes ◽  
High Dose ◽  
Funding Sources ◽  
Review Protocol ◽  
The Mean ◽  
The Impact ◽  
Over Time ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiovascular adaptations as a result of exercise conducted at high-intensity and high-volume are often termed the ‘Athlete’s heart’. Studies have shown that these cardiovascular adaptations vary between sexes. It is important that both sexes are well represented in this literature. However, many studies assessing the impact of high-dose exercise on cardiovascular outcomes under-recruit female participants. Purpose This scoping review aimed to evaluate the representation of females in studies assessing the impact of high-dose exercise on cardiovascular outcomes and demonstrate how this has changed over time. Methods The scoping review protocol as outlined by Arksey and O’Malley was used. OVID and EMBASE databases were searched and studies independently reviewed by two reviewers. Studies must have investigated the effects of high-dose exercise on cardiovascular outcomes. To assess how the recruitment of females has changed over time, two methods were used. One, the median study date was used to categorise studies into two groups. Two, studies were divided into deciles to form ten equal groups over the study period. Mean percentage of female recruitment and percentage of studies that failed to include females were calculated. Results Overall, 250 studies were included. Over half the studies (50.8%, n = 127) did not include female participants. Only 3.2% (n = 8) did not include male participants. Overall, mean percentage recruitment was 18.2%. The mean percentage of recruitment was 14.5% before 2011 and 21.8% after 2011. The most recent decile of studies demonstrated the highest mean percentage of female recruitment (29.3%) and lowest number of studies that did not include female participants (26.9%). Conclusion Female participants are significantly underrepresented in studies assessing cardiovascular outcomes caused by high-dose exercise. The most recent studies show that female recruitment may be improving, however, this still falls significantly short for equal representation. Risk factors, progression and management of cardiovascular diseases vary between sexes, hence, translating findings from male dominated data is not appropriate. Future investigators should aim to establish barriers and strategies to optimise fair recruitment. Mean percentage females recruited per study (%) Percentage studies that do not include women (%) Overall (n = 250) 18.2 50.8 (n = 127) Studies before 2011 (n = 121) 14.5 59.5 (n = 72) Studies after 2011 (n = 129) 21.8 42.6 (n = 55) Table 1: Female recruitment characteristics. The year 2011 (median study year) was chosen as this divides all included studies into two equal groups.

scholarly journals Risk assessment of cyber-attacks on telemetry-enabled cardiac implantable electronic devices (CIED)

2020 ◽  
Author(s):  
Mikaëla Ngamboé ◽  
Paul Berthier ◽  
Nader Ammari ◽  
Katia Dyrda ◽  
José M. Fernandez
Keyword(s):  
Risk Assessment ◽  
Analytical Approach ◽  
Electronic Devices ◽  
Cyber Attacks ◽  
Acceptable Risk ◽  
Cardiac Implantable Electronic Devices ◽  
Entry Points ◽  
Management Plans ◽  
The Impact ◽  
Intellectual Property Theft

Abstract Cardiac implantable electronic devices (CIED) are vulnerable to radio frequency (RF) cyber-attacks. Besides, CIED communicate with medical equipment whose telemetry capabilities and IP connectivity are creating new entry points that may be used by attackers. Therefore, it remains crucial to perform a cybersecurity risk assessment of CIED and the systems they rely on to determine the gravity of threats, address the riskiest ones on a priority basis, and develop effective risk management plans. In this study, we carry out such risk assessment according to the ISO/IEC 27005 standard and the NIST SP 800-30 guide. We employed a threat-oriented analytical approach and divided the analysis into three parts, an actor-based analysis to determine the impact of the attacks, a scenario-based analysis to measure the probability of occurrence of threats, and a combined analysis to identify the riskiest attack outcomes. The results show that vulnerabilities on the RF interface of CIED represent an acceptable risk, whereas the network and Internet connectivity of the systems they rely on represent an important potential risk. Further analysis reveals that the damages of these cyber-attacks could spread further to affect manufacturers through intellectual property theft or physicians by affecting their reputation.

scholarly journals Home Management of Heart Failure and Arrhythmias in Patients with Cardiac Devices during Pandemic

2021 ◽  
Vol 10 (8) ◽  
pp. 1618
Author(s):  
Andrea Matteucci ◽  
Michela Bonanni ◽  
Marco Centioni ◽  
Federico Zanin ◽  
Francesco Geuna ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Hospital Admissions ◽  
Electronic Devices ◽  
Home Monitoring ◽  
Home Management ◽  
Cardiac Implantable Electronic Devices ◽  
Cardiac Devices ◽  
The Impact

Background: The in-hospital management of patients with cardiac implantable electronic devices (CIEDs) changed early in the COVID-19 pandemic. Routine in-hospital controls of CIEDs were converted into remote home monitoring (HM). The aim of our study was to investigate the impact of the lockdown period on CIEDs patients and its influence on in-hospital admissions through the analysis of HM data. Methods: We analysed data recorded from 312 patients with HM during the national quarantine related to COVID-19 and then compared data from the same period of 2019. Results: We observed a reduction in the number of HM events in 2020 when compared to 2019. Non-sustained ventricular tachycardia episodes decreased (18.3% vs. 9.9% p = 0.002) as well as atrial fibrillation episodes (29.2% vs. 22.4% p = 0.019). In contrast, heart failure (HF) alarm activation was lower in 2019 than in 2020 (17% vs. 25.3% p = 0.012). Hospital admissions for critical events recorded with CIEDs dropped in 2020, including those for HF. Conclusions: HM, combined with telemedicine use, has ensured the surveillance of CIED patients. In 2020, arrhythmic events and hospital admissions decreased significantly compared to 2019. Moreover, in 2020, patients with HF arrived in hospital in a worse clinical condition compared to previous months.

scholarly journals Impact of COVID-19 Pandemic on Remote Monitoring of Cardiac Implantable Electronic Devices in Italy: Results of a Survey Promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

2021 ◽  
Vol 10 (18) ◽  
pp. 4086
Author(s):  
Massimiliano Maines ◽  
Pietro Palmisano ◽  
Maurizio Del Greco ◽  
Donato Melissano ◽  
Silvana De Bonis ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Electronic Devices ◽  
Cardiac Pacing ◽  
Median Number ◽  
Temporal Perspective ◽  
Cardiac Implantable Electronic Devices ◽  
Outpatient Visits ◽  
Exponential Increase ◽  
Number Of Patients ◽  
The Impact

The COVID-19 pandemic has had a profound impact on the organisation of health care in Italy, with an acceleration in the development of telemedicine. To assess the impact of the COVID-19 pandemic on the spread of remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) in Italy, a survey addressed to cardiologists operating in all Italian CIED-implanting centres was launched. A total of 127 cardiologists from 116 Italian arrhythmia centres took part in the survey, 41.0% of all 283 CIED-implanting centres operating in Italy in 2019. All participating centres declared to use RM of CIEDs. COVID-19 pandemic resulted in an increase in the use of RM in 83 (71.6%) participating centres. In a temporal perspective, an increase in the median number of patients per centre followed up by RM was found from 2012 to 2017, followed by an exponential increase from 2017 to 2020. In 36 participating centres (31.0%) a telehealth visits service was activated as a replacement for in-person outpatient visits (in patients with or without CIED) during the COVID-19 pandemic. COVID-19 pandemic has caused an acceleration in the use of RM of CIEDs and in the use of telemedicine in the clinical practice of cardiology.

Infections in Cardiac Implantable Electronic Devices: Diagnosis and Management in a Referral Center

2017 ◽  
Vol 70 (5) ◽  
pp. 355-362
Author(s):  
Encarnación Gutiérrez Carretero ◽  
Eduardo Arana Rueda ◽  
José Manuel Lomas Cabezas ◽  
Fernando Laviana Martínez ◽  
Manuel Villa Gil-Ortega ◽  
...  
Keyword(s):  
Electronic Devices ◽  
Referral Center ◽  
Diagnosis And Management ◽  
Cardiac Implantable Electronic Devices

scholarly journals Remote Monitoring of Cardiac Implantable Electronic Devices in Patients Undergoing Hybrid Comprehensive Telerehabilitation in Comparison to the Usual Care. Subanalysis from Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomised Clinical Trial

2020 ◽  
Vol 9 (11) ◽  
pp. 3729
Author(s):  
Sławomir Pluta ◽  
Ewa Piotrowicz ◽  
Ryszard Piotrowicz ◽  
Ewa Lewicka ◽  
Wojciech Zaręba ◽  
...  
Keyword(s):  
Heart Failure ◽  
Usual Care ◽  
Remote Monitoring ◽  
Electronic Devices ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Cardiac Implantable Electronic Devices ◽  
Hospitalised Patients ◽  
The Impact

Background: The impact of cardiac rehabilitation on the number of alerts in patients with remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) is unknown. We compared alerts in RM and outcomes in patients with CIEDs undergoing hybrid comprehensive telerehabilitation (HCTR) versus usual care (UC). Methods: Patients with heart failure (HF) after a hospitalization due to worsening HF within the last 6 months (New York Heart Association (NYHA) class I-III and left ventricular ejection fraction (LVEF) ≤40%) were enrolled in the TELEREH-HF study and randomised 1:1 to HCTR or UC. Patients with HCTR and CIEDs received RM (HCTR-RM). Patients with UC and CIEDs were offered RM optionally (UC-RM). Data from the initial 9 weeks of the study were analysed. Results: Of 850 enrolled patients, 208 were in the HCTR-RM group and 62 in the UC-RM group. The HCTR-RM group was less likely to have alerts of intrathoracic impedance (TI) decrease (p < 0.001), atrial fibrillation (AF) occurrence (p = 0.031) and lower mean number of alerts per patient associated with TI decrease (p < 0.0001) and AF (p = 0.019) than the UC-RM group. HCTR significantly decreased the occurrence of alerts in RM of CIEDs, 0.360 (95%CI, 0.189–0.686; p = 0.002), in multivariable regression analysis. There were two deaths in the HCTR-RM group (0.96%) and no deaths in the UC-RM group (p = 1.0). There were no differences in the number of hospitalised patients between the HCTR-RM and UC-RM group (p = 1.0). Conclusions: HCTR significantly reduced the number of patients with RM alerts of CIEDs related to TI decrease and AF occurrence. There were no differences in mortality or hospitalisation rates between HCTR-RM and UC-RM groups.

Sign in / Sign up

Export Citation Format

Share Document