[Remote monitoring of atrial fibrillation and heart failure]

In the last years, remote monitoring systems have been continuously updated and implemented by new algorithms to ensure proper and highly individualized management of patients with pacemakers or implantable defibrillators. The clinical history of patients with implantable devices is frequently complicated by the presence of atrial fibrillation and heart failure, often coexisting in the same subject, which are frequently responsible for major events. These patients, therefore, are those who benefit most from the remote monitoring of implantable devices. In patients with atrial fibrillation, remote monitoring allows the early detection of even short-term or asymptomatic arrhythmic episodes with a significant impact on treatment choices about thromboembolic and antiarrhythmic prophylaxis. In patients with heart failure, wearing devices for cardiac resynchronization therapy, remote monitoring allows a multiparametric evaluation on the clinical status of the patient including determination of heart rate variability, intrathoracic impedance, physical activity, weight and blood pressure. The early detection of any arrhythmia episodes or significant changes in any of the parameters recorded by remote control can identify patients at risk of acute events and allow us to change therapy quickly and adequately.