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Remote monitoring of implantable cardiac devices: current state and future directions

Ganeshan, Raj; Enriquez, Alan, D.; Freeman, James, V.

Current Opinion in Cardiology: January 2018 - Volume 33 - Issue 1 - p 20–30
doi: 10.1097/HCO.0000000000000471
ARRHYTHMIAS: Edited by David Birnie

Purpose of review Recent evidence has demonstrated substantial benefits associated with remote monitoring of cardiac implantable electronic devices (CIEDs), and treatment guidelines have endorsed the use of remote monitoring. Familiarity with the features of remote monitoring systems and the data supporting its use are vital for physicians’ care for patients with CEIDs.

Recent findings Remote monitoring remains underutilized, but its use is expanding including in new practice settings including emergency departments. Patient experience and outcomes are positive, with earlier detection of clinical events such as atrial fibrillation, reductions in inappropriate implantable cardioverter-defibrillator (ICD) shocks and potentially a decrease in mortality with frequent remote monitoring utilizaiton. Rates of hospitalization are reduced among remote monitoring users, and the replacement of outpatient follow-up visits with remote monitoring transmissions has been shown to be well tolerated. In addition, health resource utilization is lower and remote monitoring has been associated with considerable cost savings. A dose relationship exists between use of remote monitoring and patient outcomes, and those with early and high transmission rates have superior outcomes.

Summary Remote monitoring provides clinicians with the ability to provide comprehensive follow-up care for patients with CIEDs. Patient outcomes are improved, and resource utilization is decreased with appropriate use of remote monitoring. Future efforts must focus on improving the utilization and efficiency of remote monitoring.

Yale School of Medicine, New Haven, Connecticut, USA

Correspondence to James V. Freeman, MD, MPH, MS, Yale School of Medicine, Section of Cardiac Electrophysiology, P.O. Box 208017, New Haven, CT 06520, USA. Tel: +1 203 785 4126; fax: +1 203 785 7144; e-mail:

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