Remote monitoring of cardiovascular implantable electronic devices: prerequisite or luxury?

The number of patients implanted with cardiovascular electronic devices (CIED) like implantable defibrillators (ICD), cardiac resynchronisation (CRT) devices, and pacemakers continues to grow. These devices require regular follow-up interrogation in dedicated device clinics. Contemporary CIED are capable of wireless remote interrogation and monitoring. This technology has been proven to be technically reliable and helpful in certain conditions. It is of particular benefit in monitoring devices that are under a safety alert since it allows early identification of device malfunction and minimises the risk of under-reporting. There is also strong evidence that it helps to reduce heart failure hospitalisations in CRT and ICD patients. Furthermore, this technology proves to be very helpful in the early detection of arrhythmias like atrial fibrillation or ventricular tachyarrhythmias. Remote monitoring significantly reduces the number of follow-up visits, patients' and physicians' time spent per visit, and increases patients' adherence to follow-up visits. Future studies are needed to determine how to best allocate this new technology in a cost-effective manner.