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To date, mortality rates associated with heart diseases are dangerously increasing, making them the leading cause of death globally. From this point of view, digital technologies can provide health systems with the necessary support to increase prevention and monitoring, and improve care delivery. The present study proposes a review of the literature to understand the state of the art and the outcomes of international experiences. A reference framework is defined to develop reflections to optimize the use of resources and technologies, favoring the development of new organizational models and intervention strategies. Findings highlight the potential significance of e-health and telemedicine in supporting novel solutions and organizational models for cardiac illnesses as a response to the requirements and restrictions of patients and health systems. While privacy concerns and technology-acceptance-related issues arise, new avenues for research and clinical practice emerge, with the need to study ad hoc managerial models according to the type of patient and disease. [ABSTRACT FROM AUTHOR]

Incalculable numbers of patients in hospitals as a result of COVID-19 made the screening of heart patients arduous. Patients who need regular heart monitoring were affected the most. Telecardiology is used for regular remote heart monitoring of such patients. However, the resultant huge electrocardiogram (ECG) data obtained through regular monitoring affects available storage space and transmission bandwidth. These signals can take less space if stored or sent in a compressed form. To recover them at the receiver end, they are decompressed. We have combined telecardiology with automatic ECG arrhythmia classification using CNN and proposed an algorithm named TELecardiology using a Deep Convolution Neural Network (TELDCNN). Discrete cosine transform (DCT), 16-bit quantization, and run length encoding (RLE) were used for compression, and a convolution neural network (CNN) was applied for classification. The database was formed by combining real-time signals (taken from a designed ECG device) with an online database from Physionet. Four kinds of databases were considered and classified. The attained compression ratio was 2.56, and the classification accuracies for compressed and decompressed databases were 0.966 and 0.990, respectively. Comparing the classification performance of compressed and decompressed databases shows that the decompressed signals can classify the arrhythmias more appropriately than their compressed-only form, although at the cost of increased computational time. [ABSTRACT FROM AUTHOR]

Aims: Telecardiology is one of the most widespread applications of telemedicine. We aimed to report the design and development of a telecardiology system in the sanitary district of Cosenza, one of the largest in Italy, with a complex orography, and healthcare reorganization needs, for the management of the emergency network and daily clinical practice. Methods: Our telecardiology network connects 8 hospitals, 9 first aid centers, 20 local 118-EMS stations, 1 helicopter station, 8 hospital emergency departments, 59 hospital departments, and 3 catheterization laboratories. All data are centralized on a dedicated server, accessible from any location for real-time assessment. The quality, source, and timing of the electrocardiograms transmitted were evaluated. Results: From October 2015 to December 2019, a total of 389,970 ECGs were transmitted. The quality of ECGs was optimal in 52%, acceptable in 42%, and poor in 6% of the cases. The number of poor-quality ECGs was only 3% in the last 2 years. Out of the total, 145,097 (37.2%) were transmitted from the emergency departments and 5318 (1.4%) from the 118-EMS. Of interest, a sizable part of the ECG was related to routine clinical practice, comprising 110,556 (28.3%) from the cardiology department and 79,256 (20.3%) from other noncardiovascular departments. Finally, the average reporting time was significantly decreased compared to reporting times without a telecardiology system (5–10 vs. 45–90 min). Conclusion: Our telecardiology system provides efficient cardiology assistance for all types, settings, and phases of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

A non-uniform distribution of diagnostic information in the electrocardiogram (ECG) has been commonly accepted and is the background to several compression, denoising and watermarking methods. Gaze tracking is a widely recognized method for identification of an observer’s preferences and interest areas. The statistics of experts’ scanpaths were found to be a convenient quantitative estimate of medical information density for each particular component (i.e., wave) of the ECG record. In this paper we propose the application of generalized perceptual features to control the adaptive sampling of a digital ECG. Firstly, based on temporal distribution of the information density, local ECG bandwidth is estimated and projected to the actual positions of components in heartbeat representation. Next, the local sampling frequency is calculated pointwise and the ECG is adaptively low-pass filtered in all simultaneous channels. Finally, sample values are interpolated at new time positions forming a non-uniform time series. In evaluation of perceptual sampling, an inverse transform was used for the reconstruction of regularly sampled ECG with a percent root-mean-square difference (PRD) error of 3–5% (for compression ratios 3.0–4.7, respectively). Nevertheless, tests performed with the use of the CSE Database show good reproducibility of ECG diagnostic features, within the IEC 60601-2-25:2015 requirements, thanks to the occurrence of distortions in less relevant parts of the cardiac cycle [ABSTRACT FROM AUTHOR]

The management of cardiovascular diseases in rural areas is plagued by the limited access of rural residents to medical facilities and specialists. The development of telecardiology using information and communication technology may overcome such limitation. To shed light on the global trend of telecardiology, we summarized the available literature on rural telecardiology. Using PubMed databases, we conducted a literature review of articles published from January 2010 to December 2020. The contents and focus of each paper were then classified. Our search yielded nineteen original papers from various countries: nine in Asia, seven in Europe, two in North America, and one in Africa. The papers were divided into classified fields as follows: seven in tele-consultation, four in the telemedical system, four in the monitoring system, two in prehospital triage, and two in tele-training. Six of the seven tele-consultation papers reported the consultation from rural doctors to urban specialists. More reports of tele-consultations might be a characteristic of telecardiology specific to rural practice. Further work is necessary to clarify the improvement of cardiovascular outcomes for rural residents.

The COVID-19 pandemic has had a profound impact on the organisation of health care in Italy, with an acceleration in the development of telemedicine. To assess the impact of the COVID-19 pandemic on the spread of remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) in Italy, a survey addressed to cardiologists operating in all Italian CIED-implanting centres was launched. A total of 127 cardiologists from 116 Italian arrhythmia centres took part in the survey, 41.0% of all 283 CIED-implanting centres operating in Italy in 2019. All participating centres declared to use RM of CIEDs. COVID-19 pandemic resulted in an increase in the use of RM in 83 (71.6%) participating centres. In a temporal perspective, an increase in the median number of patients per centre followed up by RM was found from 2012 to 2017, followed by an exponential increase from 2017 to 2020. In 36 participating centres (31.0%) a telehealth visits service was activated as a replacement for in-person outpatient visits (in patients with or without CIED) during the COVID-19 pandemic. COVID-19 pandemic has caused an acceleration in the use of RM of CIEDs and in the use of telemedicine in the clinical practice of cardiology. [ABSTRACT FROM AUTHOR]

Introduction: Adverse effects on personalized care and outcomes of cardiovascular diseases (CVD) could occur if health systems do not work in an efficient manner. The pandemic caused by COVID-19 has opened new perspectives for the execution and advancement of cardiovascular tests through telemedicine platforms. Objective: This study aimed to analyze the usefulness of telemedical systems for providing personal care in the prevention of CVD. Methods: A systematic review analysis was conducted on the literature available from libraries such as PubMed (Medline), Scopus (Embase), and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Data available in the last 10 years (2011–2020) were also examined by PRISMA guidelines. The selected studies were divided into two categories: (1) benefits of telemedicine in CVD prevention, and (2) recent progress in telemedical services for personalized care of CVD. Results: The literature search produced 587 documents, and 19 articles were considered in this review. Results highlighted that the timely delivery of preventive care for CVD which can be implemented virtually can benefit and modify morbidity and mortality. This could also reduce the pressure on hospitals by decreasing acute CVD occurrence among the general population. The use of these technologies can also help to reduce access to hospitals and other medical devices when not necessary. Conclusions: Telemedicine platforms can be used for regular checkups for CVD and contribute to preventing the occurrence of acute events and more in general the progression of CVD. [ABSTRACT FROM AUTHOR]

Background: New sensor technologies in wearables and other consumer health devices open up promising opportunities to collect real-world data. As cardiovascular diseases remain the number one reason for disease and mortality worldwide, cardiology offers potent monitoring use cases with patients in their out-of-hospital daily routines. Therefore, the aim of this systematic review is to investigate the status quo of studies monitoring patients with cardiovascular risks and patients suffering from cardiovascular diseases in a telemedical setting using not only a smartphone-based app, but also consumer health devices such as wearables and other sensor-based devices., Methods: A literature search was conducted across five databases, and the results were examined according to the study protocols, technical approaches, and qualitative and quantitative parameters measured., Results: Out of 166 articles, 8 studies were included in this systematic review; these cover interventional and observational monitoring approaches in the area of cardiovascular diseases, heart failure, and atrial fibrillation using various app, wearable, and health device combinations., Conclusions: Depending on the researcher's motivation, a fusion of apps, patient-reported outcome measures, and non-invasive sensors can be orchestrated in a meaningful way, adding major contributions to monitoring concepts for both individual patients and larger cohorts.