Post-procedure follow-up
The follow-up of patients after recent ablation or device placement have been significantly virtualized. After device implantation, each patient is discharged with remote monitoring device. To minimize vulnerable patient exposure to the high-risk hospital setting, telemedicine services have been enabled for video-visits between provider and patient. Furthermore, due to the ongoing COVID-19 national emergency, the Centers for Medicare and Medicaid services have relaxed HIPAA requirements for telehealth visits. To improve accessibility for patients, video chat applications such as Apple FaceTime, Facebook Messenger, Google or Skype may be used, as long as patients are aware of the third-party privacy risks10. These visits have been used to evaluate for post-procedure pain or palpitations.
Similarly, after an ablation, patients may use the digital electrocardiogram recording devices such as Apple Watch or Kardia application (AliveCor, Mountain View, CA) in lieu of a follow-up post-procedure electrocardiogram. If there is concern for recurrent arrhythmia, at home Holter monitoring may be arranged by mailing the apparatus to the patient with instructions. Lastly, if antiarrhythmic drug initiation is required, frequent transmissions may be used to estimate QTc interval change after dosages.