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Antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during COVID-19 social distancing

The epidemiological necessity for distancing during the COVID-19 pandemic has resulted in postponement of non-emergent hospitalizations and increase use of telemedicine. The feasibility of virtual antiarrhythmic drug (AAD) loading specifically with digital QTc electrocardiographic monitoring (EM) in...

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Autores principales: Shah, Rajan L, Kapoor, Ridhima, Bonnett, Colleen, Ottoboni, Linda K, Tacklind, Christine, Tsiperfal, Angela, Perez, Marco V
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083679/
https://www.ncbi.nlm.nih.gov/pubmed/37155657
http://dx.doi.org/10.1093/ehjdh/ztab034
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author Shah, Rajan L
Kapoor, Ridhima
Bonnett, Colleen
Ottoboni, Linda K
Tacklind, Christine
Tsiperfal, Angela
Perez, Marco V
author_facet Shah, Rajan L
Kapoor, Ridhima
Bonnett, Colleen
Ottoboni, Linda K
Tacklind, Christine
Tsiperfal, Angela
Perez, Marco V
author_sort Shah, Rajan L
collection PubMed
description The epidemiological necessity for distancing during the COVID-19 pandemic has resulted in postponement of non-emergent hospitalizations and increase use of telemedicine. The feasibility of virtual antiarrhythmic drug (AAD) loading specifically with digital QTc electrocardiographic monitoring (EM) in conjunction with telemedicine video visits is not well established. We tested the hypothesis that existing digital health technologies and virtual communication platforms could provide EM and support medically guided AAD loading for patients with symptomatic tachyarrhythmia in the ambulatory setting, while reducing physical contact between patient and healthcare system. A prospective pilot, case series was approved by the institutional ethics committee, entailing three subjects with symptomatic arrhythmia during the COVID-19 pandemic who were enrolled for virtual AAD loading at home. Clinicians met with participants twice daily via video visits conducted after QTc analysis (Kardia 6L mobile sensor) and telemetry review (Mobile Cardiac Outpatient Telemetry of silent arrhythmias). Participants received direct instruction to either terminate the study or proceed with the next single dose of AAD. All participants completed contactless loading of five AAD doses, without untoward event. Scheduled video visits allowed dialogue and participant counselling where decision-making was guided by remote review of EM. Participant adherence with transmissions and scheduled visits was 98.3%; a single electrocardiogram was delayed beyond the 2 hours of post-dose schedule. This virtual approach reduced overall expenditures based on retrospective comparison with previous AAD load hospitalizations. We found that a ‘virtual hospitalization’ for AAD loading with remote EM and twice-daily virtual rounding is feasible using existing digital health technologies.
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spelling pubmed-80836792021-05-03 Antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during COVID-19 social distancing Shah, Rajan L Kapoor, Ridhima Bonnett, Colleen Ottoboni, Linda K Tacklind, Christine Tsiperfal, Angela Perez, Marco V Eur Heart J Digit Health Short Reports The epidemiological necessity for distancing during the COVID-19 pandemic has resulted in postponement of non-emergent hospitalizations and increase use of telemedicine. The feasibility of virtual antiarrhythmic drug (AAD) loading specifically with digital QTc electrocardiographic monitoring (EM) in conjunction with telemedicine video visits is not well established. We tested the hypothesis that existing digital health technologies and virtual communication platforms could provide EM and support medically guided AAD loading for patients with symptomatic tachyarrhythmia in the ambulatory setting, while reducing physical contact between patient and healthcare system. A prospective pilot, case series was approved by the institutional ethics committee, entailing three subjects with symptomatic arrhythmia during the COVID-19 pandemic who were enrolled for virtual AAD loading at home. Clinicians met with participants twice daily via video visits conducted after QTc analysis (Kardia 6L mobile sensor) and telemetry review (Mobile Cardiac Outpatient Telemetry of silent arrhythmias). Participants received direct instruction to either terminate the study or proceed with the next single dose of AAD. All participants completed contactless loading of five AAD doses, without untoward event. Scheduled video visits allowed dialogue and participant counselling where decision-making was guided by remote review of EM. Participant adherence with transmissions and scheduled visits was 98.3%; a single electrocardiogram was delayed beyond the 2 hours of post-dose schedule. This virtual approach reduced overall expenditures based on retrospective comparison with previous AAD load hospitalizations. We found that a ‘virtual hospitalization’ for AAD loading with remote EM and twice-daily virtual rounding is feasible using existing digital health technologies. Oxford University Press 2021-03-25 /pmc/articles/PMC8083679/ /pubmed/37155657 http://dx.doi.org/10.1093/ehjdh/ztab034 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Short Reports
Shah, Rajan L
Kapoor, Ridhima
Bonnett, Colleen
Ottoboni, Linda K
Tacklind, Christine
Tsiperfal, Angela
Perez, Marco V
Antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during COVID-19 social distancing
title Antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during COVID-19 social distancing
title_full Antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during COVID-19 social distancing
title_fullStr Antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during COVID-19 social distancing
title_full_unstemmed Antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during COVID-19 social distancing
title_short Antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during COVID-19 social distancing
title_sort antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during covid-19 social distancing
topic Short Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083679/
https://www.ncbi.nlm.nih.gov/pubmed/37155657
http://dx.doi.org/10.1093/ehjdh/ztab034
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