Remote monitoring of cardiac implantable electrical devices in Europe: quo vadis?

Abstract

This editorial refers to ‘Implementation and reimbursement of remote monitoring for cardiac implantable electronic devices in Europe: a survey from the Health Economics Committee of the European Heart Rhythm Association’ by G.H. Mairesse et al ., on page 814–818. Remote monitoring (RM) of cardiac implantable electrical devices (CIEDs) is the application of communication technology to patients carrying a pacemaker (PM), an implantable cardioverter-defibrillator (ICD) or a device for cardiac resynchronization therapy (CRT). As a matter of fact, while communication of data over distance is already a standard practice in many fields (manufacturing, banking, and business services), in the healthcare setting we are still at an early explorative phase. Remote monitoring of CIEDs has been the subject of pilot projects performed in leading centres, modelling studies, controlled trials, and economic studies. In general, these evaluations indicated that RM is an attractive technology and should be implemented and validated in ‘real world’ clinical practice.1–9 Follow-up of CIEDs using RM is already included in the Consensus Guidelines on cardiac pacing and resynchronization therapy issued by the European Society of Cardiology (ESC) in 2013,10 which delivered the following recommendation: ‘Device-based remote monitoring should be considered in order to provide earlier detection of clinical problems (e.g. ventricular tachyarrhythmias, atrial fibrillation) and technical issues (e.g. lead fracture, insulation defect)’ and assigned it class IIa recommendation, with a level of evidence B. However, despite this amount of support, RM is not at present a fully accepted standard of care in patients with a CIED, within the heterogeneous organizational, financial, and regulatory settings in Europe.11 In this issue of EP-Europace , Mairesse et al. 12 present the result of a survey initiated …