Remote monitoring for implantable defibrillators: a nationwide survey in Italy.
BACKGROUND
Remote monitoring (RM) permits home interrogation of implantable cardioverter defibrillator (ICD) and provides an alternative option to frequent in-person visits.


OBJECTIVE
The Italia-RM survey aimed to investigate the current practice of ICD follow-up in Italy and to evaluate the adoption and routine use of RM.


METHODS
An ad hoc questionnaire on RM adoption and resource use during in-clinic and remote follow-up sessions was completed in 206 Italian implanting centers.


RESULTS
The frequency of routine in-clinic ICD visits was 2 per year in 158/206 (76.7%) centers, 3 per year in 37/206 (18.0%) centers, and 4 per year in 10/206 (4.9%) centers. Follow-up examinations were performed by a cardiologist in 203/206 (98.5%) centers, and by more than one health care worker in 184/206 (89.3%) centers. There were 137/206 (66.5%) responding centers that had already adopted an RM system, the proportion of ICD patients remotely monitored being 15% for single- and dual-chamber ICD and 20% for cardiac resynchronization therapy ICD. Remote ICD interrogations were scheduled every 3 months, and were performed by a cardiologist in 124/137 (90.5%) centers. After the adoption of RM, the mean time between in-clinic visits increased from 5 (SD 1) to 8 (SD 3) months (P<.001).


CONCLUSIONS
In current clinical practice, in-clinic ICD follow-up visits consume a large amount of health care resources. The results of this survey show that RM has only partially been adopted in Italy and, although many centers have begun to implement RM in their clinical practice, the majority of their patients continue to be routinely followed-up by means of in-clinic visits.
Azienda Ospedaliero Universitaria Ospedali Riuniti, Cardiology Clinic, Ancona, Italy. marioluzi@virgilio.it.
Mario
M
Luzi
Antonio
A
De Simone
Loira
L
Leoni
Claudia
C
Amellone
Ennio
E
Pisanò
Stefano
S
Favale
Massimo
M
Iacoviello
Raffaele
R
Luise
Maria Grazia
MG
Bongiorni
Giuseppe
G
Stabile
Vincenzo
V
La Rocca
Franco
F
Folino
Alessandro
A
Capucci
Antonio
A
D'Onofrio
Francesco
F
Accardi
Sergio
S
Valsecchi
Gianfranco
G
Buia
follow-up; implantable defibrillator; remote monitoring