Real-time Technical Support Using a Remote Technology During Cardiac Implantable Electronic Device Follow-up: A Preliminary Multicenter Experience in Clinical Practice

Valter Bianchi; Maria Silvia Negroni; Domenico Pecora; Giovanni Bisignani; Giuseppe Damiano Sanna; Stefano Nardi; Manuela Azzara; Carmelo La Greca; Concetta Torchia; Gavino Casu; Luigi Argenziano; Monica Campari; Sergio Valsecchi; Antonio D'Onofrio

doi:10.19102/icrm.2024.15114

Real-time Technical Support Using a Remote Technology During Cardiac Implantable Electronic Device Follow-up: A Preliminary Multicenter Experience in Clinical Practice

J Innov Card Rhythm Manag. 2024 Nov 15;15(11):6070-6078. doi: 10.19102/icrm.2024.15114. eCollection 2024 Nov.

Authors

Affiliations

¹ "Unità Operativa di Elettrofisiologia, Studio e Terapia delle Aritmie," Monaldi Hospital, Naples, Italy.
² Ospedale Civile, Vigevano, Italy.
³ Fondazione Poliambulanza, Brescia, Italy.
⁴ Castrovillari Hospital, Cosenza, Italy.
⁵ Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy.
⁶ Ospedale Evangelico "Villa Betania," Naples, Italy.
⁷ Pineta Grande Hospital, Castel Volturno, Italy.
⁸ Boston Scientific Italia, Milan, Italy.

Abstract

Industry-employed allied professionals (IEAPs) provide technical assistance to physicians during cardiac implantable electronic device (CIED) implantation, programming, troubleshooting, and follow-up. The Heart Connect™ application (Boston Scientific Inc., Marlborough, MA, USA) is a data-sharing system that enables remote access and display sharing of the CIED Programmer. This report aims to describe the preliminary experience of remote IEAP support through the application during CIED follow-up in clinical practice. The application was downloaded on the programmer, and network connections were established and tested at six Italian centers. Staff members were trained and online meetings were scheduled with IEAPs during consecutive CIED follow-up visits. Data and user feedback were collected. A total of 20 operators received training, and online meetings were conducted during 208 patient visits. Of these, 202 (97%) visits were successfully completed with remote support, without the need for additional medical or technical assistance. The connection quality, audio, and video were rated as good or excellent in ≥95% of sessions. The average duration of online meetings ranged from 6-16 min, depending on the supported session type. Comprehensive CIED checks and tests were performed during the visits, leading to the identification of relevant conditions or programming changes in 29% of visits. All operators found the application to be user-friendly and effective. Overall, satisfaction with the remote support service was rated high in 80% of responses, particularly for managing unscheduled CIED follow-up visits. In conclusion, remote support during CIED follow-up appears to be feasible, effective, and well accepted. It offers a viable alternative to traditional on-site IEAP support for both scheduled and unscheduled follow-up visits.

Keywords: Cardiac implantable electronic devices; implantable cardioverter-defibrillator; remote support; subcutaneous implantable cardioverter-defibrillator screening; telemedicine.