[Cardiac pacemaker as bridge to cardiac telemonitoring]

Modern pacemakers and electrodes are equipped with supplementary features that can be utilized for many problems related to cardiac diagnosis and therapy management. Especially the recording and computer-assisted analysis of intramyocardial electrograms (IEGM), particularly of ventricular evoked responses (VER), supplies important information. The IEGMs are transmitted with large bandwidth from the implanted pacemaker to an extracorporeal receiver and from there via Internet to a central data processing station, where a specially designed software for IEGM processing is available. An individual password secured account is installed for each user. After signal processing is completed, a comprehensive patient report including trend courses and relevant clinical data is provided and can be utilized by the user for further decisions. Using this basic structure, CHARM (Computerized Heart Acute Rejection Monitoring), a system for non-invasive rejection monitoring after heart transplantation, has been developed and successfully evaluated in a clinical environment.