CIED Remote monitoring okt 2011 nvh

Remote monitoring of cardiac implanted electronic devices (CIED: pacemaker, cardiac resynchronization therapy
device and implantable cardioverter defibrillator) has been developed for technical controls and follow-up using
transtelephonic data transmission. In addition, automatic or patient triggered alerts to the cardiologist or allied
professional can respond if necessary with various interventions. The advantage of remote monitoring appears
obvious in impending CIED failures and suspected symptoms but is less likely in routine follow-up of CIED. For this
follow-up the indications, quality of care, costs and cost-effectiveness and patient satisfaction have to be determined
before remote CIED monitoring can be applied in daily practice. Nevertheless remote CIED monitoring expands
rapidly in the Netherlands without professional agreements about methodology, responsibilities of all parties
involved and that of the device patient, and reimbursement.
The purpose of this consensus document on remote CIED monitoring and follow-up is to lay the base for a
nationwide, uniform implementation in the Netherlands. This report describes the technical communication, current
indications, benefits and limitations of remote CIED monitoring and follow-up, the role of the patient and device
manufacturer and costs and reimbursement. The view of cardiology experts and of other disciplines in conjunction
with literature was incorporated in a preliminary series of recommendations. In addition, an overview of questions
related to remote CIED monitoring to be answered is given. This consensus document can be used for future
guidelines for the Dutch profession.