Remote monitoring of cardiac implantable electronic devices

Abstract

Cardiac implantable electronic devices (CIEDs) are used with increasing frequency for the diagnosis and treatment of cardiac arrhythmias. In Europe, a total number of 550,000 pacemakers and 180,000 defibrillators were implanted in 2014. Follow-up of these patients is a large challenge to the health system and requires a substantial amount of resources, both with regard to time, travel expenses and access to qualified personel. Remote monitoring through transmission of information from the CIED to a server accessible from the hospital is possible. Such remote monitoring may improve follow-up in a number of ways: Convenience for the patient: The patient can get a reassuring letter or phone call from the hospital and does not have to travel to the out-patient clinic. Cost-saving for the hospital, the society, the patient and for family members: Travel expenses as well as the time for patients, caregivers and hospital staff is reduced. Aid clinical decision making / tailor drug therapy: Remote monitoring can help the physician decide when to start, stop and change doses of antiarrhythmic drugs and anticoagulation. Safety when it comes to battery status, lead integrity etc: The system can alarm hospital personell about technical issues which require reprogramming og replacement. The presentation will give examples of heart conditions requiring a CIED, such as sick sinus node, atrioventricular block and ventricular tachycardia, and give a brief description of the implantation process. Furthermore, the way remote monitoring can be useful for the above mentioned reasons will be illustrated.