title: Remote monitoring of patients with cardiac implantable electronic devices: a Southeast Asian, single-centre pilot study.
abstract: BACKGROUND
  Remote monitoring of cardiac implantable electronic devices (CIED) has been shown to improve patient safety and reduce in-office visits. We report our experience with remote monitoring via the Medtronic CareLink(®) network.
  
  
  METHODS
  Patients were followed up for six months with scheduled monthly remote monitoring transmissions in addition to routine in-office checks. The efficacy of remote monitoring was evaluated by recording compliance to transmissions, number of device alerts requiring intervention and time from transmission to review. Questionnaires were administered to evaluate the experiences of patients, physicians and medical technicians.
  
  
  RESULTS
  A total of 57 patients were enrolled; 16 (28.1%) had permanent pacemakers, 34 (59.6%) had implantable cardioverter defibrillators and 7 (12.3%) had cardiac resynchronisation therapy defibrillators. Overall, of 334 remote transmissions scheduled, 73.7% were on time, 14.5% were overdue and 11.8% were missed. 84.6% of wireless transmissions were on time, compared to 53.8% of non-wireless transmissions. Among all transmissions, 4.4% contained alerts for which physicians were informed and only 1.8% required intervention. 98.6% of remote transmissions were reviewed by the second working day. 73.2% of patients preferred remote monitoring. Physicians agreed that remote transmissions provided information equivalent to in-office checks 97.1% of the time. 77.8% of medical technicians felt that remote monitoring would help the hospital improve patient management. No adverse events were reported.
  
  
  CONCLUSIONS
  Remote monitoring of CIED is safe and feasible. It has possible benefits to patient safety through earlier detection of arrhythmias or device malfunction, permitting earlier intervention. Wireless remote monitoring, in particular, may improve compliance to device monitoring. Patients may prefer remote monitoring due to possible improvements in quality of life.
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore.
authors.forename: Paul Chun Yih
authors.initials: PC
authors.lastname: Lim
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore.
authors.forename: Audry Shan Yin
authors.initials: AS
authors.lastname: Lee
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore.
authors.forename: Kelvin Chi Ming
authors.initials: KC
authors.lastname: Chua
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore.
authors.forename: Eric Tien Siang
authors.initials: ET
authors.lastname: Lim
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore.
authors.forename: Daniel Thuan Tee
authors.initials: DT
authors.lastname: Chong
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore.
authors.forename: Boon Yew
authors.initials: BY
authors.lastname: Tan
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore.
authors.forename: Kah Leng
authors.initials: KL
authors.lastname: Ho
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore.
authors.forename: Wee Siong
authors.initials: WS
authors.lastname: Teo
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore.
authors.forename: Chi Keong
authors.initials: CK
authors.lastname: Ching
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010138:Pacemaker, Artificial; D061214:Patient Safety; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D019114:Remote Consultation / Q000379:methods*; D012846:Singapore; D011795:Surveys and Questionnaires
keywords: cardiac implantable electronic devices; remote monitoring