COVID-19 – A message from Trudie Lobban, Founder & Trustee, Arrhythmia Alliance

TO ALL CARDIAC ARRHYTHMIA TEAMS (please share with colleagues)

We are very much aware of the pressure the NHS are under in these un-precedented times. Arrhythmia Alliance / AF Association / STARS have more than tripled the number of calls to our Helpline, e-mails and forums from worried, anxious patients and carers. Appointments are being cancelled/postponed, plus they have concerns as to whether they might be at high risk of COVID-19.

We have been exploring ways that we may be able to alleviate some of the pressure on our already overstretched NHS services and also the safety of patients. We are aware that many of you have already started to increase your remote monitoring services in order to keep patients safely managed at home. After discussions with leading clinicians and industry, Arrhythmia Alliance would like to offer, for those that may need it, support and a service to alleviate the work involved for remote monitoring.

The majority of High-Power devices are already remotely managed, this may vary from centre to centre. It is predicted the largest demand for additional remote follow up will be for Brady and CRT-P patients. Understandably there are insufficient monitors & physiologist resource to meet this demand instantly. Leading EP’s suggest the following recommendations to help with patient prioritisation.

Patients who fall into the following two criteria should be considered priority for remote monitoring:

1. Devices at RRT/EOL with no underlying rhythm
2. Patients on an increased follow up schedule e.g. more than one follow up scheduled per year (as this would indicate there is reason to more closely monitor them without increasing their risk of COVID-19 by bringing them into the hospital environment)

We should also consider patients identified by the government as high risk for COVID (1.5 million patients who received a government notification week beginning 23rd March)

Following individual and collaborative discussions, industry have offered assistance, working with Arrhythmia Alliance. Some industry partners are able to provide shipping of remote monitors direct to the patient, providing a Helpline of ex-NHS physiologists, now employed by industry, who can provide guidance on how to set up their remote monitors and ongoing technical support. Currently not all partners are available to provide these services, however each and every partner is looking into how they can help on an individual hospital basis.

Arrhythmia Alliance and its sister charities 01789 867501 / 01789 867502 / 01789 867503 / info@heartrhythmalliance.org are here to act as the point of contact for patient enquires to provide support for concerned patients and to provide signposting service to appropriate device manufactures for technical questions relating to remote monitoring.

GDPR confidentiality can be overcome if the patient consents to their name/phone number/e-mail and (in the event of shipping a remote monitor) address. This can be done verbally or in writing. This then allows the clinic to provide the details to Arrhythmia Alliance or alternatively ask the patient to call the Arrhythmia Alliance. Patients could also be signposted directly to industry for technical support in using their remote monitor.

Arrhythmia Alliance has also contacted the Chair of our All Party Parliamentary Group, Barry Sheerman MP who has immediately written to Matt Hancock MP, Health Minister to make him aware of this key service which a charity is offering to help save costs, time and importantly lives by reducing the number of patients visiting hospitals.

Here are some example patient flows –

1. Patient contacts Arrhythmia Alliance (01789 867501 / 502 / 503) regarding questions, support or information (e mail: info@heartrhythmalliance.org)

A-A encourage the patient to contact the manufacturer directly for remote monitoring technical related enquires:
1. Abbot – Merlin 0800 389 2714
2. Boston Scientific – Latitude 0800 678 1644
3. Biotronik 01869 362107
4. Microport (formally Sorin) 0800 026 0213

2. Patients who contact the hospital regarding remote monitoring or seeking information and support are directed to Arrhythmia Alliance (01789 867501 /502/503 / info@heartrhythmalliance.org) who will deal with the enquiry or forward to appropriate manufacturer if technical.

3. Any specific clinical issues will be escalated directly to the hospital clinic.

4. Both Arrhythmia Alliance and each industry partner will abide by strict confidentiality and only share the information with the patients clinic and with direct consent from the patient as per GDPR guidelines.

We have the support of leading clinicians, industry and our All Party Parliamentary Group. We very much hope this offer of support will help individual clinics and importantly worried, anxious patients during this critical time.

We have also arranged that ECG mobile monitoring, patches and holters can be shipped direct to patients to alleviate pressure on your teams. Please direct your patients or contact me directly if you would like further information.

We are open to all other suggestions of help if there are any specific requests from centres.

We look forward to hearing from you and are ready and able to lend our support.

On behalf of Arrhythmia Alliance / AF Association / STARS and all industry we would like to thank all NHS staff for the dedication and commitment being shown during this worrying period.