P410 ROLE OF TELEMEDICINE IN PRIMARY AND SECONDARY PREVENTION OF CARDIOVASCULAR DISEASES

Abstract

Abstract Cardiovascular diseases have a high prevalence and incidence and are associated with a high rate of mortality and hospitalization; this is reflected in a reduction in quality of life and a high health care expenditure. The aim of our study was to evaluate the effectiveness of telemedicine in primary and secondary prevention, through the use of ECG, ABPM and Holter monitoring. Health Telematic Network, in collaboration with the University of Brescia and Federfarma, has installed in 6527 territorial pharmacies distributed in the country, a telematic network interconnected to a single Telemedicine platform, where cardiologists are available for H24 reporting and teleconsultation. The pharmacies performed 12–lead ECG in healthy subjects, with cardiovascular risk factors or ongoing symptoms referable to the cardiovascular system, ABPM in accordance with the guidelines for hypertension and Holter ECG in symptomatic patients (heart palpitations, syncope, lipothymias) or positive history for brady and tachyarrhythmias. In the period between 2016 and October 2021, we analyzed 660508 exams: 411526 ECG, 143869 cardiac Holter and 105113 ABPM. Of the 411526 ECGs, 14.5% of tracings showed abnormalities not compatible with the reported anamnestic data, therefore 59671 users were sent to the caregiver for further evaluation or diagnostic investigation; in 1.5% of cases, major abnormalities were detected, necessitating immediate referral of the patient to the emergency department. Of the 105113 ABPM, 37.2% of the examinations revealed abnormal blood pressure trends according to the SIIA classification, 39102 users were sent to the physician for the appropriate diagnostic and therapeutic measures. Of the 143869 Holters, 26326 patients (18.3%) were referred to the attending physician for major arrhythmias, 3008 patients (2.1%) were referred to the emergency department for red code arrhythmias (VT, grade 3 BAV, long QTc, high or low ventricular response AF with critical pauses). Our data show the important role of a Telemedicine network in primary and secondary cardiovascular prevention, able to provide early diagnosis and treatment of major events; the use of a national telemedicine network has also proved effective in the appropriate referral of subjects to the Emergency Department, with a positive impact in terms of health care expenditure containment.