Prof. Bulent Gorenek,
Remote monitoring of cardiac rhythm devices is a relatively new technology. The devices using this technology enable wireless remote interrogation and monitoring and automatically send reports and special alerts on a daily basis. This allows physicians to respond more proactively to changes in patient or device status, to triage patient care more appropriately, and perform the post-implant ambulatory follow-ups more efficiently.
The first speaker of the session, P. Mabo, presented data on pacemakers and implantable cardioverter-defibrillators (ICD). COMPAS Trial, which was presented last year during ESC Congress, gave us more useful information about the effectiveness of such a type of PM. Remote control in ICD patients is another important subject. Two trials are already published; TRUST trial and CONNECT trial. EVATE trial and ECOST trial are presented this year at ESC congress. And the results of these trails showed that: remote monitoring in ICD patents is safe, no clear evidence that remote monitoring can contribute to prevent major cardiovascular events and clear evidence that remote monitoring reduces the risk and number of inappropriate therapies. However, there is no evidence showing that it is cost effective at that time.
The second speaker F. Braunschweig talked about heart failure. It looks like there are some limitations in the use of remote monitoring in heart failure patients. It is too early to use this technology routinely in daily practice in heart failure patients. At the moment, remote monitoring can be used only for selected patients because of its limitations.
Dr. Boriani’s topic was really important; he talked about the legal issues. Informing patients about the meaning of this technology can partly be a legal solution, but I think it will never be a complete solution. Following the patients working hours and working days can be a suggestion but in my opinion we have to take the responsibility of the patients 24 hours and 7 days.
Data exchange between remote monitoring databases and local electronic patient record system was the last talk, given by Dr. E T. van der Velde. It was also a very interesting talk including many messages for using this technology more effectively.
In conclusion, it is clear that remote monitoring is an important step helping the physicians managing the patients.
Remote monitoring of cardiac rythm devices: present and future
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