Ferrick AM, Raj SR, Deneke T, Kojodjojo P, Lopez-Cabanillas N, Abe H, Boveda S, Chew DS, Choi JI, Dagres N, Dalal AS, Dechert BE, Frazier-Mills CG, Gilbert O, Han JK, Hewit S, Kneeland C, DeEllen Mirza S, Mittal S, Ricci RP, Runte M, Sinclair S, Alkmim-Teixeira R, Vandenberk B, Varma N. 2023 HRS/EHRA/APHRS/LAHRS expert consensus statement on practical management of the remote device clinic. Heart Rhythm. 2023 May 19:S1547-5271(23)02011-8. doi: 10.1016/j.hrthm.2023.03.1525. Epub ahead of print. PMID: 37211145.
Take-home messages
- For patients with cardiovascular implantable electronic devices (CIED), remote monitoring (RM) is the standard of care.
- Prompt patient enrollment and maintenance of regular connectivity with long-term adherence to RM accomplished by individualized patient and caregiver education is essential to an effective RM program.
- Adequate staffing using both clinical and nonclinical personnel with appropriate patient-to-staff ratios and dedicated time to perform defined roles and responsibilities are essential for managing RM clinic workflows.
- Clinical staff in the RM clinic should be appropriately educated and/or certified and participate in ongoing quality assurance and improvement programs.
- Programming alerts specific to device type and indication with established mechanisms for promptly dealing with high-priority alerts can moderate increasing data volume and workload for RM programs.
- Communicating RM device results with patients, their health care providers, and the patient electronic medical record in a secure and confidential manner should be accomplished according to individual device clinic workflows.
- A relationship between RM clinics and device manufacturers for bidirectional exchange of ideas for staff training, patient education, patient care services, and management of safety advisories and recalls is imperative.
- Use of third-party resources may offer financial and practical benefits for dealing with increased device clinic volume.
- Pediatric patients with CIEDs on RM require scheduling similar to that for RM of adult patients but may have special needs requiring additional considerations.
- Implantable loop recorders require immediate connectivity to RM with special programming needs based on the patient’s clinical indication for the implantable loop recorder.
- Alert-based RM that relies on continuous connectivity allowing for extended time intervals between in-office device interrogations.