CONGRESS ABSTRACT

Telemedicine (TM) offers significant potential for managing chronic conditions like heart failure (HF), where it has proven highly effective. The TeleCuore project, launched at Piacenza Hospital, evaluates the feasibility of TM in HF care, aiming to improve outcomes, enhance hospital-community collaboration, and reduce unnecessary visits (Figure 1). Launched in February 2023, TeleCuore enrolled 304 HF patients by 2024, with 257 completing a six-month follow-up. Most participants had HF with reduced ejection fraction (HFrEF, 57.6%), and ischemic heart disease was the most prevalent underlying condition (47.5%). Telemonitoring devices were provided to 204 outpatients (79.4%) who had experienced at least one episode of clinical destabilization within the previous 12 months, while 53 patients (20.6%) received telemonitoring devices following a hospitalization for HF. At a mean follow-up of 9.3 months, 12.4% of enrolled patients (32/257) exhibited signs of HF decompensation (Figure 2). Management was predominantly outpatient-based, with 54.5% of cases identified through telemonitoring anomalies. Of these patients, 10 (55.6%) were assessed via teleconsultation, while the remaining 8 (44.4%) were scheduled for in-person visits to the specialized clinic within 48 hours. Only 7 patients required Day-Service visits to administer intravenous diuretic therapy. Of the remaining 14 cases (45.5%), 10 patients (71.4%) were referred to the Emergency Department (ED) following monitoring anomalies and the identification of HF symptoms during telephone contact. In 4 cases (28.6%), patients independently went to the ED due to symptoms suggestive of acute HF, despite the absence of predictive parametric anomalies. Among these 14 patients, only 5 (15.6%) required hospitalization for decongestion and optimization of circulatory compensation. Six-month questionnaires revealed high patient satisfaction, with an average score of 9.02/10, though one-third reported issues with the mobile app (Figure 3). Interestingly, patients had an average of just 1.3 scheduled visits during the observation period. The initial results highlight TeleCuore's effectiveness in reducing hospitalizations and unnecessary visits while being well-received by patients. Further analyses comparing outcomes with non-participating patients will better define its impact.