title: In-hospital follow-up of implantable cardioverter defibrillator and pacemaker carriers: patients' inconvenience and points of view. A four-hospital Italian survey.
abstract: OBJECTIVE
  The increasing volume of pacemaker (PM) and implantable cardioverter defibrillator (ICD) implants and problems related to their functioning have highlighted the issue of device follow-ups. Patients' convenience regarding device visits has been little investigated. This work aims at surveying patients' efforts in attending the in-office PM/ICD follow-ups and at evaluating their expectations.
  
  
  RESULTS
  In four Italian referral centres, over a 3-month period, a 20-point questionnaire was completed by all consecutive patients at in-hospital PM/ICD visits. In total, 1109 questionnaire/patients were evaluated. Pacemakers were 68%, ICDs 16%, and cardiac resynchronizations (CRTs) (PM + ICD) 16%; 38% were females; mean age was 75 ± 11 years. Almost all were scheduled visits. There was frequent reprogramming and clinical examination, even after 6 months from implant. Perceived inconvenience for the in-office follow-up was relevant in 35% of cases; attitudes towards remote monitoring were positive in 88% of cases. Inter-group analysis showed some significant difference: PM patients were older and more frequently female; ICD carriers were younger, had the highest rate of clinical evaluation, a longer journey time, and the most positive opinion about remote follow-up. Cardiac resynchronization patients had a longer waiting time and the lowest inconvenience. Overall inconvenience was independently predicted by increasing age, lengthy travelling times, and being accompanied; favourable opinions about remote monitoring were predicted by overall inconvenience, and, in ICD carriers only, by lack of clinical examination.
  
  
  CONCLUSIONS
  Patients' perceptions of in-hospital PM/ICD visits were affected by age and by journey modalities. Individual factors seem to affect both opinions about in-office visits and expectations towards a possible remote follow-up.
authors.affiliation: Cardiology Department, Santa Chiara Hospital, Trento, Italy. lorena.gramegna@apss.tn.it
authors.forename: Lorena
authors.initials: L
authors.lastname: Gramegna
authors.forename: Claudia
authors.initials: C
authors.lastname: Tomasi
authors.forename: Gianni
authors.initials: G
authors.lastname: Gasparini
authors.forename: Greta
authors.initials: G
authors.lastname: Scaboro
authors.forename: Francesco
authors.initials: F
authors.lastname: Zanon
authors.forename: Graziano
authors.initials: G
authors.lastname: Boaretto
authors.forename: Ruggero
authors.initials: R
authors.lastname: Tomei
authors.forename: Luca
authors.initials: L
authors.lastname: Tomasi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000523:psychology; D009819:Office Visits; D010138:Pacemaker, Artificial / Q000523:psychology*; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires