Abstract 11264: The Impact of the COVID-19 Pandemic on Cardiac Implantable Device Monitoring in Urban and Suburban Settings

Abstract

Introduction: Remote and in-person monitoring of cardiac implantable devices is an important component to the overall healthcare of cardiology patients. The impact of the pandemic on follow-up and missed appointment rates at cardiology device clinics after the onset of shutdowns is unclear. We analyzed the impact of the COVID-19 pandemic on in-person and remote appointment no-show rates across a large network of cardiology device clinics, including three urban hub clinics and thirteen suburban and rural spoke sites. Methods: 60,750 encounters at Emory Healthcare’s Cardiology Device Clinic between 1/1/2019-12/31/2019 (“pre-COVID”) and 8/1/2020-7/31/2021 (“post-COVID”) were included. Visits were stratified by “in-person” and “remote” appointment types and analyzed according to no-show or completed status. Subgroup analysis was performed of geographic location (urban vs suburban) clinic sites. A chi-square test was used to analyze statistical significance (p < 0.05). Results: The cohort consisted of 26,356 “pre-COVID” and 34,394 “post-COVID” scheduled device visits. The overall no-show rates were higher in the post-COVID time frame (16.5% in 2019 and 19% in 2021-2021, p < 0.001). The higher no-show rates were similar for in-person and remote visits (19.5% vs 21.3% p <0.01 in-person; 15.6% vs 18.5% p <0.001 remote). There were differences in types of no-show rates among urban versus sub-urban clinic sites. For urban sites, there was no impact on in-person no-show rates (20.8% vs 20.3%, p = 0.64) for in-person appointments, but a significant difference (13.6% vs 17.3%, p < 0.01) for remote appointments. In contrast, for suburban sites, pre and post-COVID missed appointment rates showed effects on in-person visits (15.7% vs 23.4%, p < 0.01), but not for remote appointments (48.2% vs 46.9%, p = .56). Conclusions: The COVID-19 pandemic impacted long-term in-person and remote device monitoring rates significantly. The effects were different depending on urban versus suburban site location. This analysis of over 60,000 device monitoring visits revealed a substantial impact on no-show rates for all visits and site-specific trends for the type of no-show affected, which may help in the design of higher-adherence follow up schedules in the post-COVID era.