Bridging the Gap: Remote Evaluation and Programming of Cardiac Implantable Devices in Medically Underserved Areas.
| Autor: | Ploux S; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), Pessac, France. Electronic address: sylvain.ploux@gmail.com., Strik M; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), Pessac, France. Electronic address: https://twitter.com/StrikMarc., Varma N; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA., Bouteiller XP; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), Pessac, France., Carlier L; Bergerac, France., Lissandreau S; Ribérac, France., Ben Boujema T; Mimizan, France., Boursier D; Soulac-sur-Mer, France., Hugot E; Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), Pessac, France., Haïssaguerre M; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), Pessac, France., Benali K; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), Pessac, France. Electronic address: https://twitter.com/KarimBenali42., Bordachar P; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), Pessac, France. Electronic address: https://twitter.com/CHUBordeaux. |
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| Jazyk: | angličtina |
| Zdroj: | JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2024 Nov 05. Date of Electronic Publication: 2024 Nov 05. |
| DOI: | 10.1016/j.jacep.2024.09.027 |
| Abstrakt: | Background: Delivering care in medically underserved areas (MUA) is a public health challenge. Objectives: The purpose of this study was to evaluate the advantages of a noncommercial multivendor solution for remote interrogation and programming of cardiac implantable electronic devices (CIEDs) among inhabitants of MUAs. Methods: This prospective comparative study evaluated benefits and safety of remote CIEDs evaluation in patients living >100 km from the Bordeaux University Hospital. A conventional in-person evaluation at the Bordeaux hospital was compared with a remote evaluation performed 6 months later at a nurse office close to the patient home. The technical solution consisted of remote controlling CIED programmers from the 5 main manufacturers allowing evaluation of all kinds of CIEDs. Results: A majority of the 34 included patients (94%) were satisfied with the remote evaluation strategy. To attend the in-person evaluation at the Bordeaux Hospital, the patients covered a median distance of 253 km (ICR: 221-258 km) compared with 9 km (ICR: 6-19 km) (P < 0.001) to get to the nurse's office. The use of a medical vehicle was reduced by a factor 7 (44% vs 6%; P = 0.001) with the remote evaluation, which translated into a reduction in the total traveling cost per patient by a factor 32 (96 Euros [87-268 Euros] vs 3 Euros [2-8 Euros]; P < 0.001). The travel carbon footprint was 14 times lower (28 Kg CO Conclusions: Remote evaluation of CIEDS in patients living MUA is feasible and safe. This approach is associated with a high level of satisfaction, lower economic and ecological costs compared with the in-person assessment in this population. (Remote Programming of Cardiac Implantable Electronic Devices 2 [REACT 2]; NCT06272344). Competing Interests: Funding Support and Author Disclosures This study received financial support from the French Government as part of the “Investments of the Future” program managed by the National Research Agency (ANR), Grant reference ANR-10-IAHU-04. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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