Remote monitoring of patients with heart failure during the first national lockdown for COVID-19 in France

Author:

Ploux Sylvain12ORCID,Strik Marc12,Abu-Alrub Saer13,Ramirez F Daniel14,Buliard Samuel1,Marchand Hugo1,Picard François1,Eschalier Romain3,Haïssaguerre Michel12,Bordachar Pierre12

Affiliation:

1. Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Electrophysiology and Pacing Department, F-33600 Pessac, France

2. IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France

3. Cardiology Department, Clermont Université, Université d’Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France

4. Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, H-3406, Ottawa, ON K1Y 4W7, Canada

Abstract

Abstract Aims Multiparametric remote monitoring of patients with heart failure (HF) has the potential to mitigate the health risks of lockdowns for COVID-19. We aimed to compare healthcare use, physiological variables, and HF decompensations during 1 month before and during the first month of the first French national lockdown for COVID-19 among patients undergoing remote monitoring. Methods and results Transmitted vital parameters and data from cardiac implantable electronic devices were analysed in 51 patients. Medical contact was defined as the sum of visits and days of hospitalization. The lockdown was associated with a marked decrease in cardiology medical contact (118 days before vs. 26 days during, −77%, P = 0.003) and overall medical contact (180 days before vs. 79 days during, −58%, P = 0.005). Patient adherence with remote monitoring was 84 ± 21% before and 87 ± 19% during lockdown. The lockdown was not associated with significant changes in various parameters, including physical activity (2 ± 1 to 2 ± 1 h/day), weight (83 ± 16 to 83 ± 16 kg), systolic blood pressure (121 ± 19 to 121 ± 18 mmHg), heart rate (68 ± 10 to 67 ± 10 b.p.m.), heart rate variability (89 ± 44 to 78 ± 46 ms, P = 0.05), atrial fibrillation burden (84 ± 146 vs. 86 ± 146 h/month), or thoracic impedance (66 ± 8 to 66 ± 9 Ω). Seven cases of HF decompensations were observed before lockdown, all but one of which required hospitalization, vs. six during lockdown, all but one of which were managed remotely. Conclusions The lockdown restrictions caused a marked decrease in healthcare use but no significant change in the clinical status of HF patients under multiparametric remote monitoring.

Funder

French Government

National Research Agency

CHU Clermont-Ferrand

Publisher

Oxford University Press (OUP)

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