INTRODUCTION
In January 31, 2020, the World
Health Organization declared a public health emergency of international
concern for the outbreak of the novel Severe Acute Respiratory Syndrome
Coronavirus-2 (SARS-CoV-2). The infection rapidly reached pandemic
levels, with Veneto and Lombardy being the first Italian Regions to be
heavily affected. The steep increasing number of coronavirus disease
2019 (COVID-19) cases led the Italian Government to issue executive
orders for virus containment on a national level in March 11. By that
date, patients with a confirmed diagnosis of COVID-19 were about 225.000
in Italy and 7.800 in Lazio, of which one third were in Rome (1). On a
public health perspective, while COVID-19 patients requiring
professional care were congesting the hospitals, a reorganization of
healthcare service delivery, mostly non-urgent or non-emergent ones, was
deemed necessary. Yet, early efforts were made to secure an efficient
and safe elective patient care (e.g., social distancing, mobility
restrictions, use of personal protective equipment).
Over the last decade, remote monitoring (RM) system has profoundly
transformed the standard of care for patients with cardiac electronic
implantable devices (CIEDs). RM provides access to the same information
of an in-person evaluation (IPE) via data transmission from CIEDs to
dedicated platforms easily accessible by medical staff. Mounting
evidence has confirmed its usefulness for early detection of atrial and
ventricular arrhythmias, as well as monitoring of system performance
[e.g., lead failure and battery depletion (2-5)]. Additional
benefits were also demonstrated among heart failure (HF) patients in
terms of preventing unfavourable cardiovascular events and reducing
hospital readmissions (6-10).
In line with the recently issued Heart Rhythm Society indications (11),
our Cardiac Electrophysiology and Stimulation Center (CESC) revised the
pre-existing workflow for CIED patients. The cornerstone of the novel
management protocol was the improvement of RM coverage in order to
prevent any potential risk of exposure for patients and healthcare
providers, without jeopardizing quality of care. The purpose of the
present study was to report the efficacy and patient satisfaction with
the new CIED management protocol adopted during COVID-19 Italian
lockdown.