Cardiac implantable electronic devices remote monitoring service at National University Heart Centre, Singapore

Remote monitoring (RM) is recommended as the standard of care in cardiac implantable electronic devices (CIED) management. RM allows the reduction of physical in-clinic visits during CIED follow-up, continuous monitoring and earlier detection of actionable events. Earlier studies have shown RM to be safe and effective in reducing all-cause mortality, unscheduled hospitalisations, Emergency Department and clinic visits, and inappropriate implantable cardioverter defibrillator (ICD) therapies. Apart from pacemakers and ICDs, RM is also helpful in the earlier identification of bradyarrhythmias in unexplained syncope. Across the United States and Europe, RM has been shown to be cost-effective with increased cost-savings due to reduced hospitalisation costs. Patients on RM reported increased quality of life, convenience and satisfaction, with many preferring the use of RM in their follow-up care. However, the lack of healthcare system reimbursements and the need for adequate staffing may impede RM adoption. Despite its benefits, the uptake of RM is heterogenous and remains low in Asia. Challenges to the adoption of RM in Asia include access to healthcare, geographical location, socioeconomic status and the lack of RM infrastructure. This review discusses the benefits and challenges of RM, and describes the implementation of RM at the National University Heart Centre Singapore, an academic centre with 6 CIED clinics across 2 tertiary hospitals providing care to 1.5 million people in Western Singapore.