Remote Monitoring of Cardiovascular Implantable Electronic Devices

Remote monitoring of cardiovascular implantable electronic devices (CIEDs) has transformed the management of patients with bradyarrhythmias, tachyarrhythmias and heart failure. Through secure wireless platforms, data on rhythm disturbances, device performance and physiological parameters are transmitted from the patient’s home to healthcare providers, enabling early detection of adverse events and optimisation of therapy. This approach reduces the reliance on scheduled in-person visits, lowers the burden on clinic resources and enhances patient convenience while maintaining high standards of safety. Multiparametric algorithms, incorporating metrics such as thoracic impedance, heart rate variability and physical activity, have improved the prediction of decompensation in heart failure populations. Economic evaluations have generally demonstrated cost-effectiveness for healthcare systems and patients, alongside reductions in hospitalisations and in-office encounters. The COVID-19 pandemic further accelerated adoption, highlighting the value of telemedicine and virtual consultations in maintaining continuity of care. Ongoing challenges include harmonisation of data streams into electronic health records, standardisation of alert thresholds, equitable access for diverse populations and clarity on clinical pathways following automated notifications. International guidelines now recognise remote monitoring as an integral component of CIED follow-up, underscoring its global significance and potential to deliver proactive, personalised cardiac care.

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Remote Monitoring of Cardiovascular Implantable Electronic Devices publication trend

The graph below shows the total number of articles in remote monitoring of cardiovascular implantable electronic devices across all publications each year (not limited to Nature Index journals).

Technical terms

Remote monitoring: Continuous or intermittent transmission of device-generated data from an implanted electronic device to a clinical centre without in-person contact.

Cardiac implantable electronic device (CIED): A class of devices such as pacemakers, implantable cardioverter-defibrillators and cardiac resynchronization therapy systems used to manage cardiac rhythm disorders.

Implantable cardioverter-defibrillator (ICD): A device capable of detecting and terminating life-threatening ventricular arrhythmias through electrical shocks or pacing.

Pacemaker: A device that delivers electrical impulses to maintain or regulate heart rate in bradyarrhythmias.

Multiparametric monitoring: The integration of several physiological and device-derived metrics into a composite score to predict clinical deterioration or device malfunctions.

References

1. Remote multiparametric monitoring and management of heart failure patients through cardiac implantable electronic devices. European Journal of Internal Medicine (2023).
2. Informational Postcards Increase Engagement with Remote Monitoring Among Veterans with Pacemakers and Implantable Cardioverter-Defibrillators: a Stepped-Wedge Randomized Controlled Trial. Journal of General Internal Medicine (2024).
3. The Feasibility, Effectiveness and Acceptance of Virtual Visits as Compared to In-Person Visits among Clinical Electrophysiology Patients during the COVID-19 Pandemic. Journal of Clinical Medicine (2023).