Telecardiology in heart failure - ebook
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Telecardiology in heart failure - ebook
„Ex oriente lux”
Congratulations to the authors of this first textbook focusing on the new,
emerging field of telecardiology.
This textbook is a very important step to spread more knowledge to
clinical cardiologists – from the basics to practical issues of this new facet
of digital cardiology.
For me it is not a surprise that this important textbook was written and
published in Poland first.
Pioneer work in the field, e.g. the TELEREH-HF trial, was performed in a nationwide network of
telemedical centers.
Moreover, the Polish colleagues are working hard and with open mind.
So, there is a constant exchange of new ideas even from abroad and the cooperation with international
experts, which represents another success factor for the telecardiology in Poland.
Finally, the translation of this textbook into English is a consistent next step taken to extend
its audience for the benefit of our patients.
Friedrich Köhler
Berlin, Charite. 2020-05-06
Heart failure remains a significant challenge for health care systems
worldwide. As the medical world strives to reduce the incidence of this
disease and provide patients with more comprehensive care, the telemanagement
of heart failure patients offers a promising solution.
This book presents the role of different forms of e-Health – including
e-education and self-monitoring, internet/mobile applications, structured
telephone support, telemonitoring, telerehabilitation, remote monitoring
of cardiovascular implantable electronic devices, and haemodynamic implantable
electronic devices – in providing optimal longterm management
of heart failure patients.
Introducing telecardiology to everyday clinical practice requires educating both patients and
medical teams (physicians, nurses, physiotherapists, psychologists). In this respect, it is a unique
book devoted to the use of remote monitoring in the comprehensive care of heart failure
patients. The role of telemedicine in the management of chronic diseases is supported by
European, American, and international scienti c societies.
I would like to congratulate the authors of this magnificent book, which will be extremely useful
to fellow cardiologists as well as our cardiac patients.
Alexandru Mischie MD, PhD, FESC, FAHA / Cardiologist
Head of Interv. Cardiology Department Centre Hospitalier Montlucon, France
Chair of the Tele-Cardiology WG International Society for Telemedicine & e-Health
Board Member&Communication CNCH
Past-Secretary of the ESC-ACVC
| Kategoria: | Nonfiction |
| Język: | Angielski |
| Zabezpieczenie: |
Watermark
|
| ISBN: | 978-83-200-6416-2 |
| Rozmiar pliku: | 5,3 MB |
FRAGMENT KSIĄŻKI
AUTHORS
Paweł Balsam, MD, PhD
1st Chair and Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
Prof. Maciej Banach, MD, PhD, FESC, FAHA
Department of Hypertension, Chair of Nephrology and Hypertension,
Medical University of Lodz, Lodz, Poland;
Polish Mother’s Memorial Hospital Research Institute (PMMHRI),
Lodz, Poland;
Cardiovascular Research Centre, University of Zielona Góra,
Zielona Góra, Poland
Monika Gawałko, MD
1st Chair and Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
Renata Główczyńska, MD, PhD
1st Chair and Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
Robert Irzmański, MD, PhD
Department of Internal Medicine and Cardiac Rehabilitation,
Medical University of Lodz, Lodz, Poland
Prof. Zbigniew Kalarus, MD, PhD
DMS in Zabrze, Medical University of Silesia, Katowice, Poland;
Department of Cardiology, Silesian Center for Heart Diseases,
Zabrze, Poland
Joanna Kapusta, PhD
Department of Internal Medicine and Cardiac Rehabilitation,
Medical University of Lodz, Lodz, Poland
Univ.-Prof. Dr. med. Friedrich Koehler, FESC
Charité – Universitätsmedizin Berlin,
Head of the Centre for Cardiovascular Telemedicine,
Charité-Platz 1, D -10117 Berlin, Germany
Dr. Kerstin Koehler, MD
Senior Consultant, Charité – Universitätsmedizin Berlin,
Centre for Cardiovascular Telemedicine,
Charité-Platz 1, D -10117 Berlin, Germany
Monika Kozieł, MD, PhD
1st Department of Cardiology, Silesian Centre for Heart Diseases,
Zabrze, Poland
Paweł Krzesiński, MD, PhD
Associate Professor of Military Institute of Medicine, Department
of Cardiology and Internal Diseases, Military Institute of Medicine,
Warsaw, Poland
Anna Mierzyńska, PhD HSc
Department of Rehabilitation, Centre of Postgraduate Medical
Education, Warsaw, Poland;
Department of Cardiac Surgery, Military Institute of Medicine,
Warsaw, Poland
Prof. Grzegorz Opolski, MD, PhD, FESC
1st Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
Piotr Orzechowski, MD
Telecardiology Center, Cardinal Stefan Wyszynski National Institute
of Cardiology, Warsaw, Poland
Ewa Piotrowicz, MD, PhD, FESC
Telecardiology Center, Cardinal Stefan Wyszynski National Institute
of Cardiology, Warsaw, Poland
Katarzyna Piotrowicz, MD, PhD
MS Head of Cardiac Rehabilitation Department Military Institute
of Medicine, Warsaw, Poland
Prof. Ryszard Piotrowicz, MD, PhD
Cardinal Stefan Wyszynski National Institute of Cardiology,
Warsaw, Poland;
College of Rehabilitation, Warsaw, Poland
Sławomir Pluta, MD, PhD
1st Department of Cardiology, Silesian Center for Heart Diseases,
Zabrze, Poland
Dominika Szalewska, MD, PhD
Clinic of Rehabilitation Medicine, Faculty of Health Sciences,
Medical University of Gdansk, Poland
Anna Wancerz, MD
1st Chair and Department of Cardiology Medical University of Warsaw,
Warsaw, Poland
Prof. Wojciech Zaręba, MD, PhD, FESC, FACC
Professor of Medicine/Cardiology University of Rochester
Medical Center, Rochester, NY, USAFOREWORD
Heart failure is a rapidly growing cause of morbidity, hospitalisation and mortality worldwide, with its prevalence increasing with an individual’s age. In view of pharmacotherapeutic possibilities expanding slowly, more and more importance is being attached to comprehensive care, education and rehabilitation of patients with heart failure. Taking into account an unfavourable prognosis, these measures can significantly improve patients’ quality of life and increase survival.
The pursuit of the most efficient and best use of healthcare resources has inspired medical care professionals to incorporate telemedicine technologies into care programmes.
In this book, drawing upon our own unique experience, we present the possibilities of employing this new technology – called telemedicine – for the care of patients with heart failure in the outpatient phase of care. By using the solutions proposed here providing patients with comprehensive, specialised care and rehabilitation will become possible, which subsequently leads to improved quality of life, reduced number of hospital stays and better prognosis.
Thanks to the work coordinated by Ewa Piotrowicz, Associate Professor in the Telecardiology Centre of the Stefan Cardinal Wyszynski National Institute of Cardiology, within the framework of the TELEREH-HF project, I have the honour to present this world’s first textbook on telecardiology in heart failure to English-speaking readers.
Prof. Tomasz Hryniewiecki, MD, PhD
Managing Director
Cardinal Stefan Wyszynski National Institute of CardiologyPREFACE
Telecardiology in heart failure
In this time of Covid-19 pandemic, telemedicine is experiencing a rapid development and considerable interest. It is defined as the application of advanced telecommunication technology for diagnostic, monitoring and therapeutic purposes. It enables data transmission from the patient’s whereabouts or his/her primary care provider to a specialized medical call centre. Telecardiology is a highly developed medical discipline involving almost every aspect of cardiology, including acute coronary syndromes, arrhythmias, congestive heart failure, sudden cardiac arrest and others. In particular telecardiology in heart failure is a rapidly expanding specialty in modern medicine and the publication of the present book is highly valuable: in fact, this is one of the first monographs dedicated to this matter worldwide.
The authors are researchers and scientists with extensive experience in implementing telemedicine in clinical practice acquired during the original and valuable TELEREH-HF project. The book thoroughly analyses the state of play in the use of telemedicine in the process of care for patients with heart failure, enriching it with the authors’ own experience. They presented practically all the aspects related to the comprehensive tele-management of patients with heart failure in an accessible and expert way.
At the beginning, definitions of concepts and procedures related to the use of telemedicine are presented, which makes the issues discussed easier to understand. The following chapters present the available procedures, whose implementation allows to create a comprehensive tele-management for patients with heart failure. Therefore, telecare including telephone support and remote monitoring of patients were discussed. In addition, attention was paid to the emerging possibilities of non-invasive haemodynamic remote monitoring and especially home-based use impedance cardiography, lung impedance, bioimpedance analysis. The chapter on cardiac hybrid telerehabilitation is unique. The authors implement this procedure in practice and are pioneers in this field. The TELEREH-HF project was the first multicentre study to show that hybrid telerehabilitation is effective, safe and accepted by patients. This procedure seems to be a necessary stage in the new tele-management model of care for heart failure patients.
In a following chapter, the authors proved that remote monitoring of cardiac implantable electronic devices is a very important element of tele-management. The authors also discussed the possibilities of telemonitoring hemodynamic data, such as the left atrial pressure and the pulmonary artery pressure.
The authors of the book promote a holistic, multidisciplinary approach to the problem of care for patients with heart failure, and therefore one should pay attention to the chapter devoted to the remote psychological support for patients with heart failure.
The objective approach to the analysis of the state of affairs makes the authors devote a whole chapter to discussing the restrictions that are currently associated with the use of telemedicine in patients with heart failure.
The introduction of new technologies to medicine requires new legal regulations and creates ethical dilemmas. The book also contains a chapter devoted to this topic.
In addition to a comprehensive presentation of the state of play, the authors also discuss new trends in the development of monitoring of patients with heart failure: remote-monitored pharmacotherapy (pill in the pocket, intelligent pill, i-pill), the use of artificial intelligence, lab-on-a-chip, vocal markers.
In the postscript, the concept of using telemedicine in comprehensive, long-term, coordinated care for patients with heart failure in Poland is presented.
The reader will also find the attachment at the end of the book very useful. The authors present in it, in a tabular manner recommendations for individual telemedicine procedures: classes I, IIa, IIb, III according to the definition used by ESC.
In conclusion, it is hoped that the present publication will promote even further the implementation of telecardiology in heart failure.
Prof. Massimo Francesco Piepoli, MD, PhD, FESC, FHFA, FACC
Director, Heart Failure Unit, Cardiology Department – Guglielmo da Saliceto Polichirurgico Hospital Cantone del Cristo, I-29121 Piacenza, Italy
Piacenza, April 20, 20201.
INTRODUCTION TO TELECARDIOLOGY
Wojciech Zaręba
The idea of diagnosing and treating patients at a distance has a long history. On March 22nd in 1905, Willem Einthoven, recognised as the father of electrocardiography, transmitted electrocardiograms (ECGs) from the hospital to his laboratory 1.5 km away via the telephone line. The growing popularity of telephone and radio communication in the early 20th century stimulated scientists’ imagination and the idea of “The Radio Doctor”, which appeared on the cover of Radio News magazine, was proposed in 1924 (Fig. 1.1) .
Figure 1.1. Proposed ‘The Radio Doctor’ technology presented on the cover of the April 1924 issue of Radio News magazine.
Sourced from: .
A year later, in February 1925, Hugo Gernsback published in the prestigious Science and Invention magazine the description of the telemedicine device, which he called The Radio Teledactyl (from the Greek tele – far and dactyl – finger) to indicate that this device would facilitate “feeling the patient at a distance” (Fig. 1.2.) .
Radio-medical consultations were already held in the 1920s and 1930s in Norway, Italy, France and the USA, mainly with patients on board of ships and on remote islands . In 1948, the first radiographic images were sent via telephone between West Chester and Philadelphia, 24 km apart . The first transmissions of ECGs by radio were made by Norman Jeffrey Holter in 1947, which started an era of radio-electrocardiography .
Figure 1.2. The Teledactyl — historical concept of telemedicine presented by Hugo Gernsback in the Science and Invention magazine in 1925.
In the early 1960s, video communication was first used in the USA to consult patients. For instance, the Massachusetts General Hospital in Boston established video communication with a nurses’ station at Boston Logan Airport . This communication was then enriched with the transmission of ECGs, stethoscope sounds and microscopy images. Many other applications of telemedicine were implemented for remote consultations with the transmission of signals and images . The dawn of the era of space conquests in the USSR and the USA contributed greatly to further development of transmitting vital signs of animals and humans that were launched into space.
In Poland, Professor Zdzisław Askanas’s team began using telemetry for the transmission of ECG signals in the early 1960s. During the years 1986–1987, as a young assistant at the Cardiology Division at the Medical Academy of Lodz (directed by Professor Halina Pracka), I teletransmitted signal-averaged ECGs recorded in an XYZ lead configuration to evaluate ventricular late potentials. ECG recordings took place in the hospital and were transmitted by the Łucz television dish (borrowed from Lodz television) to the Institute of Physics at Lodz University (about 3 km from the hospital). One television transmission dish was installed on the roof of the hospital, and the other on the roof of the Institute of Physics, in which there was a Mera 400 computer that averaged the ECG signal with recording of ventricular late potentials. This innovative solution was achieved in cooperation with Professor Wielisław Olejniczak’s team from Lodz University. Professor Wielisław Olejniczak was a visionary who helped advancing pioneering telemedicine solutions to my scientific work, which led to my doctoral degree in 1988. Because of the progressive computerisation and development of mobile networks, telemedicine has become a part of everyday practice in many areas of medicine.
Telecardiology, which enables transmission of ECG signals, heart rate and data from the implanted devices (pacemakers, defibrillators), has become a daily reality. Patients with heart failure require particularly intensive care, which is usually provided on an outpatient basis. Telemedicine in heart failure can be used for early diagnosis of health status deterioration, assessment of treatment, medication monitoring, assessment of physical activity, delivery of cardiac rehabilitation, as well as for monitoring of implantable devices. All these applications of telemedicine aim to improve patient’s health, physical capacity, and quality of life, and to reduce the risk of hospitalisation or death.
Paweł Balsam, MD, PhD
1st Chair and Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
Prof. Maciej Banach, MD, PhD, FESC, FAHA
Department of Hypertension, Chair of Nephrology and Hypertension,
Medical University of Lodz, Lodz, Poland;
Polish Mother’s Memorial Hospital Research Institute (PMMHRI),
Lodz, Poland;
Cardiovascular Research Centre, University of Zielona Góra,
Zielona Góra, Poland
Monika Gawałko, MD
1st Chair and Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
Renata Główczyńska, MD, PhD
1st Chair and Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
Robert Irzmański, MD, PhD
Department of Internal Medicine and Cardiac Rehabilitation,
Medical University of Lodz, Lodz, Poland
Prof. Zbigniew Kalarus, MD, PhD
DMS in Zabrze, Medical University of Silesia, Katowice, Poland;
Department of Cardiology, Silesian Center for Heart Diseases,
Zabrze, Poland
Joanna Kapusta, PhD
Department of Internal Medicine and Cardiac Rehabilitation,
Medical University of Lodz, Lodz, Poland
Univ.-Prof. Dr. med. Friedrich Koehler, FESC
Charité – Universitätsmedizin Berlin,
Head of the Centre for Cardiovascular Telemedicine,
Charité-Platz 1, D -10117 Berlin, Germany
Dr. Kerstin Koehler, MD
Senior Consultant, Charité – Universitätsmedizin Berlin,
Centre for Cardiovascular Telemedicine,
Charité-Platz 1, D -10117 Berlin, Germany
Monika Kozieł, MD, PhD
1st Department of Cardiology, Silesian Centre for Heart Diseases,
Zabrze, Poland
Paweł Krzesiński, MD, PhD
Associate Professor of Military Institute of Medicine, Department
of Cardiology and Internal Diseases, Military Institute of Medicine,
Warsaw, Poland
Anna Mierzyńska, PhD HSc
Department of Rehabilitation, Centre of Postgraduate Medical
Education, Warsaw, Poland;
Department of Cardiac Surgery, Military Institute of Medicine,
Warsaw, Poland
Prof. Grzegorz Opolski, MD, PhD, FESC
1st Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
Piotr Orzechowski, MD
Telecardiology Center, Cardinal Stefan Wyszynski National Institute
of Cardiology, Warsaw, Poland
Ewa Piotrowicz, MD, PhD, FESC
Telecardiology Center, Cardinal Stefan Wyszynski National Institute
of Cardiology, Warsaw, Poland
Katarzyna Piotrowicz, MD, PhD
MS Head of Cardiac Rehabilitation Department Military Institute
of Medicine, Warsaw, Poland
Prof. Ryszard Piotrowicz, MD, PhD
Cardinal Stefan Wyszynski National Institute of Cardiology,
Warsaw, Poland;
College of Rehabilitation, Warsaw, Poland
Sławomir Pluta, MD, PhD
1st Department of Cardiology, Silesian Center for Heart Diseases,
Zabrze, Poland
Dominika Szalewska, MD, PhD
Clinic of Rehabilitation Medicine, Faculty of Health Sciences,
Medical University of Gdansk, Poland
Anna Wancerz, MD
1st Chair and Department of Cardiology Medical University of Warsaw,
Warsaw, Poland
Prof. Wojciech Zaręba, MD, PhD, FESC, FACC
Professor of Medicine/Cardiology University of Rochester
Medical Center, Rochester, NY, USAFOREWORD
Heart failure is a rapidly growing cause of morbidity, hospitalisation and mortality worldwide, with its prevalence increasing with an individual’s age. In view of pharmacotherapeutic possibilities expanding slowly, more and more importance is being attached to comprehensive care, education and rehabilitation of patients with heart failure. Taking into account an unfavourable prognosis, these measures can significantly improve patients’ quality of life and increase survival.
The pursuit of the most efficient and best use of healthcare resources has inspired medical care professionals to incorporate telemedicine technologies into care programmes.
In this book, drawing upon our own unique experience, we present the possibilities of employing this new technology – called telemedicine – for the care of patients with heart failure in the outpatient phase of care. By using the solutions proposed here providing patients with comprehensive, specialised care and rehabilitation will become possible, which subsequently leads to improved quality of life, reduced number of hospital stays and better prognosis.
Thanks to the work coordinated by Ewa Piotrowicz, Associate Professor in the Telecardiology Centre of the Stefan Cardinal Wyszynski National Institute of Cardiology, within the framework of the TELEREH-HF project, I have the honour to present this world’s first textbook on telecardiology in heart failure to English-speaking readers.
Prof. Tomasz Hryniewiecki, MD, PhD
Managing Director
Cardinal Stefan Wyszynski National Institute of CardiologyPREFACE
Telecardiology in heart failure
In this time of Covid-19 pandemic, telemedicine is experiencing a rapid development and considerable interest. It is defined as the application of advanced telecommunication technology for diagnostic, monitoring and therapeutic purposes. It enables data transmission from the patient’s whereabouts or his/her primary care provider to a specialized medical call centre. Telecardiology is a highly developed medical discipline involving almost every aspect of cardiology, including acute coronary syndromes, arrhythmias, congestive heart failure, sudden cardiac arrest and others. In particular telecardiology in heart failure is a rapidly expanding specialty in modern medicine and the publication of the present book is highly valuable: in fact, this is one of the first monographs dedicated to this matter worldwide.
The authors are researchers and scientists with extensive experience in implementing telemedicine in clinical practice acquired during the original and valuable TELEREH-HF project. The book thoroughly analyses the state of play in the use of telemedicine in the process of care for patients with heart failure, enriching it with the authors’ own experience. They presented practically all the aspects related to the comprehensive tele-management of patients with heart failure in an accessible and expert way.
At the beginning, definitions of concepts and procedures related to the use of telemedicine are presented, which makes the issues discussed easier to understand. The following chapters present the available procedures, whose implementation allows to create a comprehensive tele-management for patients with heart failure. Therefore, telecare including telephone support and remote monitoring of patients were discussed. In addition, attention was paid to the emerging possibilities of non-invasive haemodynamic remote monitoring and especially home-based use impedance cardiography, lung impedance, bioimpedance analysis. The chapter on cardiac hybrid telerehabilitation is unique. The authors implement this procedure in practice and are pioneers in this field. The TELEREH-HF project was the first multicentre study to show that hybrid telerehabilitation is effective, safe and accepted by patients. This procedure seems to be a necessary stage in the new tele-management model of care for heart failure patients.
In a following chapter, the authors proved that remote monitoring of cardiac implantable electronic devices is a very important element of tele-management. The authors also discussed the possibilities of telemonitoring hemodynamic data, such as the left atrial pressure and the pulmonary artery pressure.
The authors of the book promote a holistic, multidisciplinary approach to the problem of care for patients with heart failure, and therefore one should pay attention to the chapter devoted to the remote psychological support for patients with heart failure.
The objective approach to the analysis of the state of affairs makes the authors devote a whole chapter to discussing the restrictions that are currently associated with the use of telemedicine in patients with heart failure.
The introduction of new technologies to medicine requires new legal regulations and creates ethical dilemmas. The book also contains a chapter devoted to this topic.
In addition to a comprehensive presentation of the state of play, the authors also discuss new trends in the development of monitoring of patients with heart failure: remote-monitored pharmacotherapy (pill in the pocket, intelligent pill, i-pill), the use of artificial intelligence, lab-on-a-chip, vocal markers.
In the postscript, the concept of using telemedicine in comprehensive, long-term, coordinated care for patients with heart failure in Poland is presented.
The reader will also find the attachment at the end of the book very useful. The authors present in it, in a tabular manner recommendations for individual telemedicine procedures: classes I, IIa, IIb, III according to the definition used by ESC.
In conclusion, it is hoped that the present publication will promote even further the implementation of telecardiology in heart failure.
Prof. Massimo Francesco Piepoli, MD, PhD, FESC, FHFA, FACC
Director, Heart Failure Unit, Cardiology Department – Guglielmo da Saliceto Polichirurgico Hospital Cantone del Cristo, I-29121 Piacenza, Italy
Piacenza, April 20, 20201.
INTRODUCTION TO TELECARDIOLOGY
Wojciech Zaręba
The idea of diagnosing and treating patients at a distance has a long history. On March 22nd in 1905, Willem Einthoven, recognised as the father of electrocardiography, transmitted electrocardiograms (ECGs) from the hospital to his laboratory 1.5 km away via the telephone line. The growing popularity of telephone and radio communication in the early 20th century stimulated scientists’ imagination and the idea of “The Radio Doctor”, which appeared on the cover of Radio News magazine, was proposed in 1924 (Fig. 1.1) .
Figure 1.1. Proposed ‘The Radio Doctor’ technology presented on the cover of the April 1924 issue of Radio News magazine.
Sourced from: .
A year later, in February 1925, Hugo Gernsback published in the prestigious Science and Invention magazine the description of the telemedicine device, which he called The Radio Teledactyl (from the Greek tele – far and dactyl – finger) to indicate that this device would facilitate “feeling the patient at a distance” (Fig. 1.2.) .
Radio-medical consultations were already held in the 1920s and 1930s in Norway, Italy, France and the USA, mainly with patients on board of ships and on remote islands . In 1948, the first radiographic images were sent via telephone between West Chester and Philadelphia, 24 km apart . The first transmissions of ECGs by radio were made by Norman Jeffrey Holter in 1947, which started an era of radio-electrocardiography .
Figure 1.2. The Teledactyl — historical concept of telemedicine presented by Hugo Gernsback in the Science and Invention magazine in 1925.
In the early 1960s, video communication was first used in the USA to consult patients. For instance, the Massachusetts General Hospital in Boston established video communication with a nurses’ station at Boston Logan Airport . This communication was then enriched with the transmission of ECGs, stethoscope sounds and microscopy images. Many other applications of telemedicine were implemented for remote consultations with the transmission of signals and images . The dawn of the era of space conquests in the USSR and the USA contributed greatly to further development of transmitting vital signs of animals and humans that were launched into space.
In Poland, Professor Zdzisław Askanas’s team began using telemetry for the transmission of ECG signals in the early 1960s. During the years 1986–1987, as a young assistant at the Cardiology Division at the Medical Academy of Lodz (directed by Professor Halina Pracka), I teletransmitted signal-averaged ECGs recorded in an XYZ lead configuration to evaluate ventricular late potentials. ECG recordings took place in the hospital and were transmitted by the Łucz television dish (borrowed from Lodz television) to the Institute of Physics at Lodz University (about 3 km from the hospital). One television transmission dish was installed on the roof of the hospital, and the other on the roof of the Institute of Physics, in which there was a Mera 400 computer that averaged the ECG signal with recording of ventricular late potentials. This innovative solution was achieved in cooperation with Professor Wielisław Olejniczak’s team from Lodz University. Professor Wielisław Olejniczak was a visionary who helped advancing pioneering telemedicine solutions to my scientific work, which led to my doctoral degree in 1988. Because of the progressive computerisation and development of mobile networks, telemedicine has become a part of everyday practice in many areas of medicine.
Telecardiology, which enables transmission of ECG signals, heart rate and data from the implanted devices (pacemakers, defibrillators), has become a daily reality. Patients with heart failure require particularly intensive care, which is usually provided on an outpatient basis. Telemedicine in heart failure can be used for early diagnosis of health status deterioration, assessment of treatment, medication monitoring, assessment of physical activity, delivery of cardiac rehabilitation, as well as for monitoring of implantable devices. All these applications of telemedicine aim to improve patient’s health, physical capacity, and quality of life, and to reduce the risk of hospitalisation or death.
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