Remote monitoring of cardiovascular implantable electronic devices in Japan

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.