New Consensus Statement Recommends Remote Monitoring as CIED Standard of Care

Posted By: HRSon: May 15, 2015

A new expert consensus statement by the Heart Rhythm Society recommends that remote monitoring (RM) become a standard of care for patients with cardiovascular implantable electronic devices (CIEDs).

The HRS Expert Consensus Statement on Remote Interrogation and Monitoring for Cardiovascular Electronic Implantable Devices was written by an international group of experts and published online this week in HeartRhythm Jurnal, the official journal of HRS.

This new approach presents a paradigm shift for managing patients with CIEDs and will be the focus of the “Clinical Document: 2015 HRS Expert Consensus Statement on Remote Monitoring” special session, which will begin at 8 a.m. today in Room 158. During the 90-minute session, an international panel of experts will discuss specific ways that remote monitoring can be efficiently implemented by patients and healthcare providers.

“We’ve seen firsthand how the constant and continuous communication between the patient’s device and the healthcare provider is improving the quality and efficiency of care,” said task force chair and lead author of the statement David Slotwiner, MD, FHRS, Hofstra School of Medicine, North Shore-Long Island Jewish Health in New Hyde Park, NY.

The new expert consensus statement builds upon the 2008 HRS/EHRA Expert Consensus on the Monitoring of Cardiovascular Implantable Electronic Devices (CIEDs) and reinforces the need for consistent follow-up. It also outlines the limitations of in-person only follow-up.

The writing group focused on organizational changes required to effectively implement RM. These changes include replacing the occasional, routine appointment to a system of nearly continuous monitoring, making it more convenient and efficient for the patient and healthcare provider. Recommendations also include an in-person evaluation at the physician’s office in response to alert notifications communicated by RM.

Other key recommendations in the expert consensus statement include:

• RM should be combined with at least one annual in-person evaluation, and all patients with CIEDs should be offered remote monitoring as part of the standard follow-up management strategy.
• Before implementing RM, each patient should be educated about the nature of RM, responsibilities and expectations, potential benefits, and limitations, and provided an explanation of how RM information may be used.
• All CIEDs should be checked through direct patient contact two to 12 weeks after being implanted.
• Specific policies should be put in place to govern program operations, roles, and responsibilities of those involved, and the expected timelines for service provision.

“There are proven advantages for the patient and we outline a specific strategy on how remote monitoring can benefit both patients and providers,” Slotwiner said. “We hope that this type of wireless, remote monitoring that provides real-time insights to the patient’s healthcare team can become a model for managing other chronic conditions.”

The expert consensus statement was developed in collaboration with the American College of Cardiology (ACC), Pediatric & Congenital Electrophysiology Society (PACES), the American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), the European Heart Rhythm Association (EHRA), and the Latin American Society of Cardiac Pacing and Electrophysiology (Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología, SOLAECE). The document was endorsed by SOLAECE, with pending endorsement from the ACC, PACES, the AHA, APHRS, and EHRA.