부산대학교 도서관

Introduction:despite good progress in the management of patients (pts) with atrial fibrillation (AF), this disease is one of the major cause of stroke, heart failure, sudden death and cardiovascular (CV) morbidity. Screening for silent AF is recommended in high risk population, especially in elderly, but often it is not applied for the absence of medical prescriptions or long waiting timesHypothesis:to evaluate the effectiveness of a remote monitoring through ECG Holter and 12-lead ECG for the screening of AFMethods:according to a Ministerial Decree, from 2010 authorized pharmacies may provide specialist outpatient care services. Health Telematic Network, in collaboration with our Cardiology University Department and Federfarma (National Association of Pharmacists), has installed in 4,008 authorized pharmacies across the Country a telematic network connected to a single Telemedicine platform where cardiologists were available for tele-consulting. In order to identify silent or symptomatic AF, 12-lead ECG and ECG Holter monitoring were performed in pts with episodes of palpitation, syncope or pre-syncope or with a history of AFResults:In 2017 and 2018 a total of 31,156 ECG Holter monitoring were performed (46% male, mean age 61 years). Among these records, 2390 (8%) showed paroxysmal or persistent AF (53% male, mean age 77?10 years). The lenght of AF episodes was greater of 6 minutes in 14% cases and mean VR was greater of 90 bpm in 406 patients (17%). History of AF was not previously known in 669 pts (28%). None of this subgroup of pts and only 18% of pts with known paroxysmal AF were taking anticoagulant therapy. In the same period 196,349 ECG were performed (mean age 78 years); 831 records showed unknown AF (5%): 356 (43%) high VR AF, 385 (46%) medium VR AF and 90 (11%) low VR AF. All the patients with unknown AF episodes or with high VR AF episodes were referred to their General Practitioner or Cardiologist for urgent evaluation and therapeutic managementConclusions:our telematic network, in which health care services can be provided timely by authorized pharmacies across all the Country, promoted early diagnosis and treatment of AF, resulting in a likely positive impact on related CV events