A pilot study of nurse-led, home-based telecardiology for patients with chronic heart failure.
We assessed the feasibility of home-based telecardiology for patients with chronic heart failure (CHF). Seventy-four CHF patients were enrolled into a programme of telephone follow-up and single-lead electrocardiography (ECG) monitoring. The patients transmitted their ECG data by fixed telephone line to a receiving station, where a nurse was available for an interactive teleconsultation. Patients were followed up for a mean (SD) of 307 (108) days; 1467 calls were analysed (213 ad hoc consultations and 1254 scheduled consultations). A total of 124 cardiovascular events were recorded. Modifications to therapy were suggested in response to 119 calls; hospital admissions were suggested for 13 patients, further investigations for 7 and a consultation with the patient's general practitioner for 13. No action was taken after 1330 calls. Twenty-two ECG abnormalities were recorded. In 63 patients receiving the beta-blocker carvedilol, the mean dosage increased from 36 to 42 mg. In the previous year there were 1.8 hospitalizations per patient, while in the follow-up period there were 0.2 hospitalizations per patient. Following up CHF patients using a nurse-led telecardiology programme seems to be feasible and useful.
Scalvini
Simonetta
S
Fondazione S Maugeri, Divisione di Cardiologia, Instituto di Ricovero e Cura a Carattere Scientifico, Gussago, Brescia, Italy. sscalvvini@fsm.it
Zanelli
Emanuela
E
Volterrani
Maurizio
M
Martinelli
Giovanna
G
Baratti
Doriana
D
Buscaya
Osvaldo
O
Baiardi
Paola
P
Glisenti
Fulvio
F
Giordano
Amerigo
A
D000368:Aged; D000553:Ambulatory Care / Q000379:methods*; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000451:nursing*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods* / Q000451:nursing; D010865:Pilot Projects; D019114:Remote Consultation / Q000592:standards*; D013689:Telephone