ABSTRACT
Introduction Remote monitoring of chronic heart failure patients started since 2018 on the Montpellier University Hospital, within the ETAPES program. Since then, the inclusion criteria and the organization within the Cardiology Department have undergone major changes. Objective Review the local status of remote monitoring since the expansion of inclusion criteria, organizational changes and the COVID health crisis. Method All statistical and clinical data come from our internal database as well as that of Air Liquide (remote monitoring service provider chosen by the University Hospital). Results Since 2018, 570 patients have been included in the remote monitoring system. Currently, the active file includes 206 patients. There has been a sharp increase in inclusions (see Fig. 1), which can be explained both by a broadening of the inclusion criteria following the COVID-19 pandemic and by a strengthening of the telemonitoring team. The average age is 69 years (younger than the national average), reflecting a tertiary center activity. In 2021, patients were mainly included via consultation (80% of patients in NYHA class 2 or 3). The average EF is 38%, again reflecting a UHC population. In parallel with the increase in the number of inclusions, we obviously note a greater number of alerts: from 54 in 2018 to more than 1000 in 2020, rather well distributed over the different months of the year. It should be noted that the filtering of alerts by the provider in charge of remote monitoring plays an important role since only 33% of alerts are directed to our center. Nearly 40% of patients have never generated an alert. For the others, we note an average of 7.8 alerts per patient. Two thirds of these alerts were related to weight variations. Concerning the symptoms responsible for alerts: mainly fatigue and weakness 45%;<10% of edema and dyspnea. After COVID, we note even more fatigue and weakness 57%, which can be explained by a deconditioning linked to the successive confinements. We do not yet have data concerning re-hospitalizations, but we already note a lower proportion of patients with heart failure among those hospitalized for acute heart failure (data from the COMET project between January and March 2022). Conclusion Even if the future of remote monitoring is uncertain, with discussions still underway for the passage into common law, it remains a more than interesting tool for our chronic heart failure patients.