Cardiac Implantable Electronic Devices Remote Programming

Remote monitoring has revolutionized the follow-up of cardiac implantable electronic device recipients, leading to both organizational benefits and improved patient survival. To fully realize the potential of a remote cardiac implantable electronic device management strategy, a 2-way communication system enabling remote programming capabilities is essential. In recent years, several initiatives have emerged to develop and evaluate indirect remote programming solutions based on the remote control of a device programmer. This hybrid approach, which mitigates cybersecurity risks, has been successfully applied in various clinical settings, from magnetic resonance imaging procedures to medically underserved regions, and has consistently demonstrated high safety and patient satisfaction. Indirect remote programming reduces the need for both patient and healthcare professional travel, thereby lowering associated costs and the carbon footprint, while shortening delays and enhancing patient safety. It provides a clear preview of the enormous potential of direct remote programming, particularly regarding equity in access to care and patient outcomes. Direct remote programming of cardiac implantable electronic devices is no longer technical a barrier and is already available for implantable cardiac monitors. In the near future, extending direct programming to therapeutic cardiac implantable electronic devices is expected to further remove geographic and logistical barriers, reduce time to intervention, and improve patient safety. This promising evolution will, however, require not only addressing cybersecurity challenges but also embracing a paradigm shift within the cardiology community.