{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T17:24:00Z","timestamp":1771608240972,"version":"3.50.1"},"reference-count":9,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"unspecified","delay-in-days":50,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2026,2,4]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delays in performing urgent coronary artery bypass graft (CABG) surgery are increasing across the UK, with national wait times now exceeding guideline targets. Prolonged preoperative admissions contribute to hospital bed pressures, increased costs and negative psychosocial effects for patients. Virtual wards using remote patient monitoring (RPM) may enable safe early discharge for clinically stable patients awaiting surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the feasibility, safety and outcomes of a virtual ward pathway using RPM for patients awaiting urgent CABG surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective, multicentre, single-arm study was conducted across three UK cardiac centres (December 2022\u2013May 2025). Eligible patients were discharged home with daily symptom reporting via a digital platform and structured clinician review. The primary outcome was preoperative major adverse cardiovascular events (MACE). Secondary outcomes included 30-day mortality, resternotomy, time to surgery, postoperative stay, readmissions and patient experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>128 patients were enrolled (mean age 61 years; 87% male). No preoperative MACE occurred (0%; 95% CI 0.0% to 2.3%). 30-day mortality was 0% (95% CI 0.0% to 2.9%), and resternotomy occurred in 2.3%, comparable to national rates. Median time from discharge to surgery was 10 days, saving an estimated 1152 inpatient bed-days. Postoperative length of stay was 7.0 days compared with a national average of 8.0 (p=0.084). Patient experience was favourable: 95% felt safe at home, and 89% found the platform easy to use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A virtual ward pathway with remote monitoring for selected patients awaiting urgent CABG was safe, feasible and associated with high patient acceptability and major reductions in inpatient utilisation. These findings support this model as a scalable approach to managing urgent surgical pathways while preserving safety and surgical timelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2025-003568","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T16:50:20Z","timestamp":1771606220000},"page":"e003568","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility, safety and outcomes of a virtual ward with remote monitoring for patients awaiting urgent coronary artery bypass graft surgery"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7631-9999","authenticated-orcid":false,"given":"Arun","family":"Kirupananthavel","sequence":"first","affiliation":[{"name":"Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Woldman","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, St Bartholomew\u2019s Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A","family":"Jones","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, St Bartholomew\u2019s Hospital, London, UK"},{"name":"Centre for Cardiovascular Medicines and Devices, Queen Mary University of London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordon","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Knight","sequence":"additional","affiliation":[{"name":"Barts and The London NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mick","family":"Ozkor","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Edmondson","sequence":"additional","affiliation":[{"name":"St Bartholomew\u2019s Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9847-070X","authenticated-orcid":false,"given":"Andrew","family":"Archbold","sequence":"additional","affiliation":[{"name":"General and Invasive Cardiology, Barts Heart Centre, St Bartholomew\u2019s Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Radley","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cora","family":"Niblock","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Johnson","sequence":"additional","affiliation":[{"name":"Mid and South Essex NHS Foundation Trust, Basildon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jade","family":"Theisinger","sequence":"additional","affiliation":[{"name":"Mid and South Essex NHS Foundation Trust, Basildon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Rossi","sequence":"additional","affiliation":[{"name":"Mid and South Essex NHS Foundation Trust, Basildon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emad","family":"AlJaaly","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihir","family":"Kelshiker","sequence":"additional","affiliation":[{"name":"Department of Cardiac Engineering, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas S","family":"Peters","sequence":"additional","affiliation":[{"name":"St Mary's Hospital and Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kulvinder","family":"Lall","sequence":"additional","affiliation":[{"name":"St Bartholomew\u2019s Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debashish","family":"Das","sequence":"additional","affiliation":[{"name":"Cardiology, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2313-2244","authenticated-orcid":false,"given":"Martin T","family":"Yates","sequence":"additional","affiliation":[{"name":"St Bartholomew\u2019s Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"2026022008501162000_13.1.e003568.1","unstructured":"NICOR . National adult cardiac surgery audit (NACSA) report 2023\/24. London National Institute for Cardiovascular Outcomes Research; 2024."},{"key":"2026022008501162000_13.1.e003568.2","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-65019-8","article-title":"An Extended Duration of the Pre-Operative Hospitalization is Associated with an Increased Risk of Healthcare-Associated Infections after Cardiac Surgery","volume":"10","author":"Sulzgruber","year":"2020","journal-title":"Sci Rep"},{"key":"2026022008501162000_13.1.e003568.3","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1097\/JCN.0000000000000792","article-title":"Associations of Preoperative Self-rated Symptoms of Anxiety and Depression on Length of Hospital Stay and Long-term Quality of Life in Patients Undergoing Cardiac Surgery","volume":"37","author":"Gorini","year":"2022","journal-title":"J Cardiovasc Nurs"},{"key":"2026022008501162000_13.1.e003568.4","doi-asserted-by":"crossref","first-page":"320","DOI":"10.7861\/clinmedicine.12-4-320","article-title":"In-depth analysis of delays to patient discharge: a metropolitan teaching hospital experience","volume":"12","author":"Hendy","year":"2012","journal-title":"Clin Med (Lond)"},{"key":"2026022008501162000_13.1.e003568.5","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy394"},{"key":"2026022008501162000_13.1.e003568.6","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu278"},{"key":"2026022008501162000_13.1.e003568.7","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/S0140-6736(18)31880-4","article-title":"Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): a randomised, controlled, parallel-group, unmasked trial","volume":"392","author":"Koehler","year":"2018","journal-title":"The Lancet"},{"key":"2026022008501162000_13.1.e003568.8","doi-asserted-by":"crossref","unstructured":"Cruz\u2010Cobo C , Bernal-Jim\u00e9nez M\u00c1 , Calle G , et al . Efficacy of a mobile health app (emotiva) regarding compliance with cardiac rehabilitation guidelines in patients with coronary artery disease. 2023. Available: https:\/\/doi.org\/10.2196\/preprints.55421","DOI":"10.2196\/preprints.55421"},{"key":"2026022008501162000_13.1.e003568.9","doi-asserted-by":"publisher","DOI":"10.3310\/AAFO2475"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2025-003568","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T16:50:24Z","timestamp":1771606224000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2025-003568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,2,20]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/openhrt-2025-003568"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2025-003568","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}