The patient with cardiomyopathy is one click away from his cardiologist
Since the first index cases were first reported in Wuhan, China in December 2019, coronavirus-2 (SARSCoV-2) has become a global pandemic affecting> 1 million people in early April. 2020 (Johns Hopkins COVID-19 DB, 2020).
In addition to systemic and respiratory complications, COVID-19 can manifest itself with acute cardiovascular syndrome (what we have termed “ACovCS”) (Hendren, Circulation 2020). This consists of a myocarditis-like syndrome that causes acute myocardial injury often associated with reduced left ventricular ejection fraction in the absence of coronary artery disease. This syndrome can be complicated by cardiac arrhythmias and / or heart failure with or without hemodynamic instability (Hendren, Circulation 2020). These complications are much more frequent in patients with heart or cardiovascular disease prior to infection.
Furthermore, the therapies used for the treatment of the COVID-19 patient in the area, namely chloroquine / hydroxychloroquine, lopinavir / ritonavir and antibiotics such as macrolides (SIMIT, 13/03/20) significantly lengthen ventricular repolarization (which we can evaluate by measuring the increased QT interval on ECG), and theoretically expose the patient to lethal arrhythmias. Finally, the COVID-19 epidemic is unfortunately creating indirect damage to the most fragile chronic patients: outpatient visits are limited to urgent and mandatory cases and contacting an urgent emergency service entails considerable risks for fragile chronic patients suffering from diseases. cardiovascular (Rosenbaum et al, NEJM 2020).
The Italian Association for the Assistance and Research of Cardiomyopathies (AICARM ONLUS) founded in 2019 thanks to the work of patients with cardiomyopathy and Prof. Franco Cecchi and Iacopo Olivotto, among the world's leading experts in this field, collects patients with heart muscle diseases from all over Italy. Among its objectives are to improve the standard of care for patients with Cardiomyopathy, to help them during the care process, both through practical information regarding centers of excellence and qualified health professionals, and - where
necessary - through financial support that guarantees access to the best care at national level.
During this epidemic, patients suffering from Cardiomyopathies find themselves living with a chronic disease that predisposes them to possible complications if infected with COVID-19, but also a decrease in checks and cardiological visits at the Centers of Excellence in the country, delaying the diagnosis of any complications such as arrhythmias, in particular arrhythmias such as atrial fibrillation that can precipitate heart failure, easily documented with an electrocardiogram.
AIRCAM aims to equip a large part of its members with cardiomyopathy with a portable digital electrocardiograph (D-HEART) specifically created and validated on the patient affected by these pathologies (Maurizi et al. IJC and EHJ). This device designed and produced in Italy, allows the patient, in total autonomy, to
- record your own electrocardiogram with a reliability identical to that of the hospital
- share it with expert cardiologists via your Smartphone
- obtain a diagnostic-therapeutic indication in a short time (max 15 minutes) without having to go to the emergency room in the hospital
The advantages would be both for patients with cardiomyopathy affected by COVID-19 in the early identification of complications and monitoring therapies, but also in those not affected by COVID-19 to carry out remote checks with their cardiologist (avoiding potentially dangerous places) and diagnosis. immediate complications of these chronic diseases.
Sector in which the project is carried out
The project "With D-Heart the patient with Cardiomyopathy is one click away from his cardiologist " it will be carried out in the context of social and health assistance on patients suffering from Cardiomyopathy (heart muscle disease).
In addition to systemic and respiratory complications, COVID-19 can cause direct problems to the heart and cardiovascular system (much more frequent in patients with heart or cardiovascular disease before infection). Furthermore, the therapies used to treat the COVID-19 patient in the area significantly lengthen ventricular repolarization (increased QT interval on ECG), theoretically predisposing the patient to lethal arrhythmias. Further indirect damage of the COVID-19 epidemic to the most fragile chronic patients concerns the reduction of specialist visits, which often does not allow for early treatment of complications and worse patient gestation (Rosenbaum et al, NEJM 2020).
AIRCAM therefore proposes to equip a large part of its members suffering from cardiomyopathy with a portable digital electrocardiograph, specifically made and validated on the patient affected by these pathologies (Maurizi et al. IJC and EHJ). This Italian device, called D-Heart allows the patient, in total autonomy, to record his own electrocardiogram with identical reliability to the hospital one and to be able to share it with expert cardiologists, obtaining a diagnostic-therapeutic indication in less than 15 minutes, in absence of risks from your home.
The advantages would be both for patients with cardiomyopathy affected by COVID-19 to identify complications early and monitor therapies, but also in those not affected by COVID-19 to carry out remote checks with their cardiologist (avoiding potentially dangerous places) and allow the immediate diagnosis of any arrhythmias.
AIRCAM therefore proposes, to respond to the management difficulties of patients affected by cardiomyopathy in affected and not affected by COVID-19:
- Equip 30 members with cardiomyopathy with the D-Heart Kit for professional homecare electrocardiogram (Electrocardiograph, disposable electrodes for 10 ECGs, charging base and case);
- Provide each member with 10 D-Heart telereferences obtained in collaboration with the Cardiology Department of San Raffaele in Milan and Telbios via the D-Heart platform;
- Training and logistical support for the operation of the project.
Structures and tools necessary for the realization of the project / initiative: With D-Heart the patient with Cardiomyopathy is one click away from his cardiologist
- 30 D-Heart Electrocardiograph Kit
- 300 D-Heart Telerefertations (10 for each patient);
- Logistic support and possible training of patients in the use of the device;