Automatic remote home monitoring of implantable cardioverter defibrillator lead and generator function: a system that tests itself everyday

The implantation of cardiac electronic devices (CIEDs) has increased exponentially over the last decade in response to widening indications. Assessment of post-implant system performance is an important responsibility but challenging in view of increasing volume, device complexity, and advisory notices. Automatic remote home monitoring (HM) may satisfy these difficult monitoring demands. When tested, HM enhanced the discovery of system issues (even when asymptomatic) and enabled prompt clinical decisions regarding conservative vs. surgical management. This form of remote monitoring may form a device management model in which near-continuous remote surveillance of CIED performance is combined with automatic self-declaration of system problems, enabling prompt medical decisions. The ability to collect detailed device-specific data, with component function assessed daily, sets a precedent for longitudinal evaluation of lead and generator performance. These characteristics have significant ramifications for CIEDs in general and patient safety.