The use and need for follow-up of cardiac electronic implantable devices, such as pacemakers and implantable defibrillators, is constantly increasing, and constitutes an ever-growing burden and cost in clinical practice and the health system in general. Telemedicine or remote, wireless home monitoring (HM) has recently come to aid in this situation and reliably retrieve information on the patient`s and device`s status and transmit it to the implanting center and physician. It thus offers considerable convenience and assurance to both patient and physician. To date this technology of remote monitoring allows continuous and episode related arrhythmia monitoring as well as continuous monitoring of the status of the implanted system (battery status, lead impedance). Preliminary data from ongoing large multicenter studies are promising and relate to the diagnostic power of telemetrically transmitted data, necessity for patient follow up, the influence of HM on the optimisation of device and medical therapy, and the impact of HM on costeffectiveness in device therapy. I N T R O D U C T I O N In contemporary cardiology the use of highly sophisticated implantable devices, such as pacemakers (PM) and implantable cardioverter defibrillators (ICD), is increasing, constituting an ever-growing burden on both clinical routine and costs. Due to the technological complexity of these devices and their use in critically ill patients regularly scheduled follow -up visits are mandatory to obtain information on both device status and performance. On top of these regularly scheduled clinical visits, event related visits further increase the burden to the health system. C U R R E N T D E V I C E F O L L O W U P S C H E M E The currently used follow-up scheme has some marked disadvantages: 1) many follow-up procedures are performed routinely only not requiring any change in device or drug therapy, 2) programmer based tests are performed under artificial conditions not reflecting real life, 3) asymptomatic arrhythmia episodes or changes in the arrhythmia pattern are hidden until the next regular follow up is performed, 4) there is REVIEW Department of Cardiology, University of Vienna, Vienna, Austria HOSPITAL CHRONICLES 2008, 3(2): 67–70 Correspondence to: Herwig Schmidinger, MD Professor of Cardiology Department of Cardiology University of Vienna Vienna, Austria E-mail: herwig.schmidinger@univie.ac.at KEy WORDS: pacemaker; implantable defibrillator; telemedicine; wireless data transmission; home monitoring;