Implementing a New Remote Monitoring Program in the Developing World – The Cleveland Clinic Abu Dhabi Experience

Background: Remote monitoring (RM) for cardiac implantable electronic devices (CIED) is a class 1A recommendation by expert consensus. RM incorporation into CIED management allows for early detection of abnormalities, improved patient satisfaction, and enhanced device clinic efficiency. Cleveland Clinic Abu Dhabi (CCAD) established the first RM program in the United Arab Emirates in 2015, with over 1000 patients enrolled. We report patient RM compliance as an indicator of the overall benefit of our service, aiming to encourage the widespread application of RM technology in the Middle East and other emerging markets. Objective: To detail the implementation and efficacy of RM service for CIED patients at CCAD to be modeled after as the standard of care for the region. Methods: Patients are enrolled in RM before hospital discharge and undergo device and wound checks one week later in the device clinic. Additional patient education is provided at that time. Subsequent follow-up includes routine in-person evaluations as well as scheduled RM transmissions. Patient compliance is measured as the proportion of received RM transmissions in relation to all scheduled transmissions. Results: A total of 1084 patients were enrolled in RM between December 2015 and May 2022. The overall RM compliance rate at 1-year post-implant was 85%. Conclusion: Our study shows that the establishment of a large-scale RM program in the Middle East region is feasible and associated with excellent patient participation and compliance. We encourage RM integration as the standard of care for CIED patients in our region and areas of the world where such integration has been lagging.