Introduction
The spread of coronavirus disease 2019 (COVID-19) has seriously affected the medical system worldwide. In addition to caring for patients suffering from COVID-19, medical staff have faced difficulties in the outpatient care of non-COVID-19 patients. Some hospitals have temporarily closed their outpatient clinics because of COVID-19 clusters, and patients with chronic disease have tended to avoid going to hospital for fear of contracting the disease. Avoiding regular consultations at hospitals/clinics might result in the worsening of chronic conditions. Currently, there is a growing demand on the part of patients and health care workers for remote monitoring systems1, 2 that use digital technologies to collect medical data from individuals, thus eliminating the need to visit a medical facility in person.
A patch-type wireless, real-time electrocardiogram (ECG) monitor (Duranta; ZAIKEN Co., Ltd. Tokyo, Japan) has been approved and already used as a Holter ECG device in Japan.3, 4 Conventionally, patients visit the hospital to have the Duranta attached. After the ECG monitoring, the patients return to the hospital to remove the device. The device is small (35 g) and attaches easily to the chest using two electrode patches. We therefore thought that patients could attach the device themselves and that the device could be sent via the postal service between the hospital and the patients’ homes. This novel usage of the Duranta would allow patients to share the telemetry ECG data with their doctors without visiting the hospital or visiting less often. Here, we report the initial experience of using the small wireless ECG monitoring device and the utility of delivery via the postal service in outpatient care in Japan.
Methods
We retrospectively analyzed the data of patients who underwent long-term ECG monitoring at Kobe University Hospital between August and December 2020 with the Duranta device that was delivered via the postal service. The data including patient characteristics, the method of delivery, ECG monitoring duration, detection of arrhythmia, and any noises or signal interruption during the ECG monitoring were analyzed. In addition, we surveyed the patients to quantify their satisfaction regarding the self-wearable ECG monitoring device delivered via the postal service. The protocol for this research project was approved by the Ethics Committee of Kobe University Hospital (Approval no. B200276).