| Purpose: The remote parameter test of CIED implantation operation supported by 5G cloud technology is a brand-new parameter test method.This study verifies the safety and effectiveness of remote parameter testing by comparing two methods of remote parameter testing and traditional intraoperative parameter testing.Methods: Include patients who underwent CIED implantation at Chengdu Third People’s Hospital affiliated to Southwest Jiaotong University from October 2020 to January 2021.According to the method of intraoperative parameter testing,the patients were divided into experimental group(remote parameter test group)and control group(traditional intraoperative parameter test group).Compare the differences between the two sets of parameter test times,test durations,and parameter test values,and compare the differences between the two sets of parameter value compliance rates.Intraoperative parameter testing includes three parameters: atrium and ventricle perception,threshold,and impedance.Observe whether the experimental group has signal jams and interruptions during the parameter test,and adverse events caused by signal jams and interruptions.Observe the number of parameter testers in and out of the operating room in the control group,the X-ray irradiation time received during the parameter test,and the X-ray irradiation dose at the same time.Results: A total of 68 CIED implanted patients were enrolled in this study,29 in the experimental group and 39 in the control group.The average age is 71.38 years old,and the proportion of women is 51.5%.Comparison of baseline data between the two groups:smoking,drinking,diabetes,atrial fibrillation,hyperlipidemia,cardiomyopathy,etc.had no significant difference(P>0.05).The proportion of patients complicated with hypertension in the experimental group was higher than that in the control group(75.9% vs.48.7%,P=0.024),and the anterior and posterior diameter of the right atrium(RA)in the experimental group was larger than that in the control group(43.57±7.85 mm vs.37.59±6.09 mm,P=0.002),the differences were statistically significant.In the experimental group,3patients had 6 signal freezes,1 time for 2 seconds,2 times for 2 seconds,and 3 times for 5seconds,which did not cause any adverse events in the patients.After the tablet computer signal card was replaced on December 29,2020,there has been no signal freeze or interruption since then.In the control group,the door was opened and closed at least 2 times and at most 28 times;during the parameter test,the parameter tester received at least 0s and at most 796s;the simultaneous exposure dose was at least 0m Gy and at most 12 m Gy.Comparison of parameter test values between the experimental group and the control group:only the RA impedance value of the experimental group is smaller than that of the control group(434±77 Ω vs.539±96Ω;P<0.001);there is no significant statistics between the other parameters of the RA and right ventricular(RV)Academic difference(P>0.05).However,comparing the parameter recommended value compliance rate between the two groups,it was found that the RA impedance of the experimental group and the control group were within the recommended range of parameter values(100% vs.100%,P>0.05).Comparing the parameter test duration and the number of parameter tests between the two groups,there was no statistically significant difference in the parameter test duration of the RA and RV between the two groups(P>0.05),but the test times of RA and RV parameters in the experimental group were more than those in the control group,and the difference was statistically significant(P<0.05).In the follow-up survey on the willingness to use the remote program-controlled follow-up system,it was found that 81.1% of the patients thought that the remote program-controlled system was more convenient and willing to continue to use the remote program-controlled follow-up system.86.5% of the patients were willing to recommend remote program control to other CIED implanted patients.Conclusion: The intraoperative remote parameter test of CIED implantation supported by5 G cloud technology is safe and reliable in the signal stable area.The effect of remote parameter testing is similar to that of traditional intraoperative parameter testing.In addition,remote parameter testing can reduce the air circulation in and out of the operating room by reducing the number of times the tester goes in and out of the operating room during the operation,and realize the "zero X-ray" contact of the parameter tester with the table,which is especially in line with the operating room control requirements under the current normal COVID-19 epidemic situation.The remote parameter test of CIED implantation operation supported by 5G cloud technology is safe and effective. |
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