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Remote monitoring recommendations for cardiac implantable electronic devices (CIEDs)

Remote monitoring recommendations for cardiac implantable electronic devices (CIEDs)
Device follow-up paradigm Class of recommendation Level of evidence
A strategy of remote CIED monitoring and interrogation, combined with at least annual in-person examination, is recommended over a calendar-based schedule of in-person CIED evaluation alone (when technically feasible). I A
All patients with CIEDs should be offered RM as part of the standard follow-up management strategy. I A
Before implementing RM, it is recommended that each patient be educated about the nature of RM, their responsibilities and expectations, potential benefits, and limitations. The occurrence of this discussion should be documented in the medical record. I E
It is recommended that all CIEDs be checked through direct patient contact 2 to 12 weeks postimplantation. I E
It may be beneficial to initiate RM within the two weeks of CIED implantation. IIa C
All patients with an implantable loop recorder with wireless data transfer capability should be enrolled in an RM program, given the daily availability of diagnostic data. I E
It is recommended that allied health care professionals responsible for interpreting RM transmissions and who are involved in subsequent patient management decisions have the same qualifications as those performing in-clinic assessments and should ideally possess IBHRE certification for device follow-up or equivalent experience. I E
It is recommended that RM programs develop and document appropriate policies and procedures to govern program operations, the roles and responsibilities of those involved in the program, and the expected timelines for providing service. I E
CIED: cardiac implantable electronic device; HRS: Heart Rhythm Society; IBHRE: International Board of Heart Rhythm Examiners; RM: remote monitoring.
Reproduced from: Slotwiner D, Varma N, Akar JG, et al. HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices. Heart Rhythm 2015; 12:e69. Illustration used with the permission of Elsevier Inc. All rights reserved.
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