ABSTRACT
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has led to a substantial reduction in elective healthcare services, in order to reduce the burden on healthcare system and infection spread. Most in-office visits for the follow-up of patients with cardiovascular implantable electronic devices (CIED) were cancelled or postponed. Remote management of CIEDs offers well established benefits and it is a valuable alternative to a face-to-face visit. We report the characteristics and outcomes of patients with CIED undergoing in-office visit in our center during the lockdown. Methods: We collected the clinical records of all consecutive patients reporting to our institute's CIED clinic for device follow-up during the government-imposed lockdown due to the COVID-19 pandemic (from 1 March to 4 May, 2020). Among patients with remote monitoring systems, an in-person visit was performed only in case of a device alarm. Files of patients without remote control were evaluated in order to establish the need of a face-to face visit. The out-patient visit was confirmed if one of the criteria reported in Table 1 was satisfied. Each patient with scheduled follow-up during the lockdown was contacted by phone to either confirm the visit in case of satisfaction of one of the above reported criteria or to inform that the scheduled visit was postponed of 6 months. Results: A total of 648 visits were scheduled for periodical CIED interrogation, 10% of patients had a device equipped with remote monitoring systems. Three hundred forty-three in-person visits were confirmed. However, only 198 patients (30% of scheduled interrogations) presented for the scheduled visit. Patients characteristics are reported in Table 2. Five visits involved patients with remote monitoring. The main reason for in-office visit was a pacing dependence (Table 3). Overall, only 14% (n. 27) of performed visits required a medical intervention including: change in CIED programming, change in pharmacological treatment, hospitalization. Conclusion: During the COVID-19 pandemic, in-office evaluation of CIED patients was significantly reduced when compared to scheduled visits. The majority of in-office visits was not followed by a medical intervention. Therefore, all these follow-up visits could have been avoided. A wider use of remote monitoring would allow a further reduction of nonessential in-person clinic visit.