Table 5.

Circumstances requiring a face-to-face consultation

Ischemic heart disease	Unstable angina
	Suspected heart failure
	Refractory angina with antianginal therapy
Heart failure	Acute refractory decompensation with outpatient increase in diuretic therapy (increase in dosage of habitual diuretic and/or temporary combination with a thiazide)
	Symptomatic hypotension refractory to a temporary outpatient reduction in conventional treatment dosage (spironolactone diuretics --> ACEIs/ARBs/ARNIs)
	Signs and/or symptoms of syncope or low cardiac output
	Heart rate > 100 o < 40 bpm in a patient with previously stable values
	Unstable ischemic chest pain
	ICD discharges or device alarms
Arrhythmias		Syncope		Palpitationsa		Other cases (eg, presyncope)
		1 episode	> 1 episode	1 episode	> 1 episode	1 episode	> 1 episode
	Significant structural heart disease	Face-to-face	Face-to-face	TeleCon	Face-to-face	TeleCon	Face-to-face
	Channelopathy	Face-to-face	Face-to-face	TeleCon	Face-to-face	TeleCon	Face-to-face
	Without significant structural heart disease	TeleCon	Face-to-face	TeleCon	TeleConb	TeleCon	TeleConb

ACEIs, angiotensin converting enzyme inhibitors; ARBs, angiotensin receptor blockers; ARNIs, angiotensin receptor neprilysin inhibitors; ICD, implantable cardioverter-defibrillator; TeleCon, teleconsultation.

^aRapid palpitations (regular or irregular) lasting over 1 minute.

^bFace-to-face if emergency department treatment is needed.