The role of remote monitoring for cardiac implantable electronic devices

At present, remote monitoring (RM) is available for almost all cardiac implantable electronic devices. RM systems allow for enhanced surveillance and earlier detection of clinically significant events. In recent guidelines, RM is a Class I indication for device follow-up, and the Expert Consensus Statement endorses the use of RM to improve patient compliance. Many clinical studies including randomized clinical trials showed favorable outcomes with RM. This technology reduces costs, allows for early detection of arrhythmias, as well as lead to malfunctions. RM also lowers hospitalization rates, decreases inappropriate implantable cardioverter defibrillator shocks, and detects asymptomatic atrial fibrillation earlier than routine office visits. However, whether RM reduces mortality remains unclear. Prevention of heart failure exacerbation with early detection of surrogate markers of heart failure with RM has not been demonstrated using a single measure such as intrathoracic impedance. However, the use of multiple parameters has encouraging early results, showing improved detection of impending heart failure exacerbation.