Remote monitoring of cardiovascular implantable electronic devices in Japan

Abstract

The number of patients with chronically implanted cardiovascular implantable electronic devices (CIEDs) keeps growing, and device clinics of major hospitals may soon be unable to fully accommodate the increasing amount of follow‐up activities. Consequently, the remote monitoring (RM) technology introduced in Japan in 2010 has been rapidly gaining widespread application in the management of CIEDs. A modern remote monitor not only acts as an alternative to a device clinic, but also as a security monitor for the device and the patient. A number of papers have confirmed the safety, feasibility, and cost‐effectiveness of RM systems. Importantly, remote monitors allow physicians to quickly detect and respond to lead problems, atrial arrhythmias, heart failure, and other adverse events, which may also improve the patients' survival rate. Several reports from Japan have demonstrated that RM systems are well accepted by both the patients and physicians. However, there remain limitations and problems of the RM technology to be solved, and rules and guidelines for monitor management should be established to fully utilize the advantages of RM systems.

Telemonitoring and Quality of Life in Patients after 12 Months Following a Pacemaker Implant: the Nordland Study, a Randomised Trial

“…The number of patients with chronically implanted cardiovascular implantable electronic devices (CIEDs) is continuously increasing, and device clinics at hospitals may soon be unable to fully cope with the increasing number of follow-up activities [1]. Current guidelines necessitate one or two follow-up assessments per year for patients implanted with a pacemaker (PM) [2].…”

“…The objective of disease management is to reduce operating costs without lowering effectiveness by creating disease-specific pathways of diagnosis and care in patients at a high risk of heart failure, thus allowing doctors to quickly detect and respond to adverse events, which may also improve patients’ health status [1,8]. Previous studies have reported that although telemedicine requires an initial financial investment, such interventions eventually result in a substantial reduction in the medical costs over a long period of time [9].…”

“…Currently, the outcomes of patients with cardiac implantable electronic devices, including improved quality of life of patients, reduced need for in-office interrogation, patient safety, and enhanced survival—which remains the most significant benefit—demonstrate the effectiveness of remote monitoring [10]. In patients implanted with pacemakers (PM), telemedicine potentially facilitates patient safety through early detection of arrhythmia or device malfunction, allowing earlier intervention, which ultimately improves the patients’ survival rate [1,11].…”