In-hospital follow-up of implantable cardioverter defibrillator and pacemaker carriers: patients inconvenience and points of view. A four-hospital Italian survey

Aims The increasing volume of pacemaker (PM) and implantable cardioverter defibrillator (ICD) implants and problems related to their functioning have highlighted the issue of device follow-ups. Patients convenience regarding device visits has been little investigated. This work aims at surveying patients efforts in attending the in-office PM/ICD follow-ups and at evaluating their expectations. Methods and results In four Italian referral centres, over a 3-month period, a 20-point questionnaire was completed by all consecutive patients at in-hospital PM/ICD visits. In total, 1109 questionnaire/patients were evaluated. Pacemakers were 68, ICDs 16, and cardiac resynchronizations (CRTs) (PM ICD) 16; 38 were females; mean age was 75 11 years. Almost all were scheduled visits. There was frequent reprogramming and clinical examination, even after 6 months from implant. Perceived inconvenience for the in-office follow-up was relevant in 35 of cases; attitudes towards remote monitoring were positive in 88 of cases. Inter-group analysis showed some significant difference: PM patients were older and more frequently female; ICD carriers were younger, had the highest rate of clinical evaluation, a longer journey time, and the most positive opinion about remote follow-up. Cardiac resynchronization patients had a longer waiting time and the lowest inconvenience. Overall inconvenience was independently predicted by increasing age, lengthy travelling times, and being accompanied; favourable opinions about remote monitoring were predicted by overall inconvenience, and, in ICD carriers only, by lack of clinical examination. Conclusions Patients perceptions of in-hospital PM/ICD visits were affected by age and by journey modalities. Individual factors seem to affect both opinions about in-office visits and expectations towards a possible remote follow-up.