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Safety and efficiency of a common and simplified protocol for pacemaker and defibrillator surveillance based on remote monitoring only: a long-term randomized trial (RM-ALONE). Eur Heart J 2019; 40:1837. 22. Watanabe E, Yamazaki F, Goto T, et al. Remote Management of Pacemaker Patients With Biennial In-Clinic Evaluation: Continuous Home Monitoring in the Japanese At-Home Study: A Randomized Clinical Trial. Circ Arrhythm Electrophysiol 2020; 13:e007734. 23. Heart Rhythm Society COVID-19 Task Force Update. Management of cardiac implantable ele ctronic devices (CIED). 2020. https://www.hrsonline.org/COVID19-Challenges-Solutions/hrs-c ovid-19-task-force-update-april-15-2020 (Accessed on December 13, 2022). 24. Akhtar Z, Montalbano N, Leung LWM, et al. Drive-Through Pacing Clinic: A Popular Response to the COVID-19 Pandemic. JACC Clin Electrophysiol 2021; 7:128. 25. Hindricks G, Elsner C, Piorkowski C, et al. Quarterly vs. yearly clinical follow-up of remotely monitored recipients of prophylactic implantable cardioverter-defibrillators: results of the REFORM trial. Eur Heart J 2014; 35:98. 26. Winters SL, Packer DL, Marchlinski FE, et al. Consensus statement on indications, guidelines for use, and recommendations for follow-up of implantable cardioverter defibrillators. North American Society of Electrophysiology and Pacing. Pacing Clin Electrophysiol 2001; 24:262. 27. Brignole M, Occhetta E, Bongiorni MG, et al. Clinical evaluation of defibrillation testing in an unselected population of 2,120 consecutive patients undergoing first implantable cardioverter-defibrillator implant. J Am Coll Cardiol 2012; 60:981. 28. Healey JS, Hohnloser SH, Glikson M, et al. Cardioverter defibrillator implantation without induction of ventricular fibrillation: a single-blind, non-inferiority, randomised controlled trial (SIMPLE). Lancet 2015; 385:785. https://www.uptodate.com/contents/cardiac-implantable-electronic-devices-patient-follow-up/print 14/19 7/6/23, 10:48 AM Cardiac implantable electronic devices: Patient follow-up - UpToDate 29. Poole JE, Johnson GW, Hellkamp AS, et al. Prognostic importance of defibrillator shocks in patients with heart failure. N Engl J Med 2008; 359:1009. 30. Bleakley JF, Akiyama T, Canadian Cardiovascular Society, et al. Driving and arrhythmias: implications of new data. Card Electrophysiol Rev 2003; 7:77. 31. Task force members, Vijgen J, Botto G, et al. Consensus statement of the European Heart Rhythm Association: updated recommendations for driving by patients with implantable cardioverter defibrillators. Europace 2009; 11:1097. 32. Ransford B, Kramer DB, Foo Kune D, et al. Cybersecurity and medical devices: A practical guide for cardiac electrophysiologists. Pacing Clin Electrophysiol 2017; 40:913. 33. Kramer DB, Fu K. Cybersecurity Concerns and Medical Devices: Lessons From a Pacemaker Advisory. JAMA 2017; 318:2077. 34. Pycroft L, Aziz TZ. Security of implantable medical devices with wireless connections: The dangers of cyber-attacks. Expert Rev Med Devices 2018; 15:403. Topic 1015 Version 39.0 https://www.uptodate.com/contents/cardiac-implantable-electronic-devices-patient-follow-up/print 15/19 7/6/23, 10:48 AM Cardiac implantable electronic devices: Patient follow-up - UpToDate GRAPHICS Remote monitoring recommendations for cardiac implantable electronic devices (CIEDs) Class of recommendation Level of evidence Device follow-up paradigm A strategy of remote CIED monitoring and interrogation, combined with at least annual in-person examination, is recommended over a calendar-based schedule of in-person CIED evaluation alone (when technically feasible). I A All patients with CIEDs should be offered RM as part of the standard follow-up management strategy. I A Before implementing RM, it is recommended that each patient be educated about the nature of RM, their responsibilities and expectations, potential benefits, and limitations. The I E occurrence of this discussion should be documented in the medical record. It is recommended that all CIEDs be checked through direct patient contact 2 to 12 weeks postimplantation. I E It may be beneficial to initiate RM within the two weeks of CIED implantation. IIa C All patients with an implantable loop recorder with wireless data transfer capability should be enrolled in an RM program, given the daily availability of diagnostic data. I E It is recommended that allied health care professionals responsible for interpreting RM transmissions and who are involved in subsequent patient management decisions have the same qualifications as those performing in-clinic I E assessments and should ideally possess IBHRE certification for device follow-up or equivalent experience. It is recommended that RM programs develop and document appropriate policies and procedures to govern program operations, the roles and responsibilities of those involved in the program, and the expected timelines for providing service. I E CIED: cardiac implantable electronic device; HRS: Heart Rhythm Society; IBHRE: International Board of Heart Rhythm Examiners; RM: remote monitoring. Reproduced from: Slotwiner D, Varma N, Akar JG, et al. HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices. Heart Rhythm 2015; 12:e69. Illustration used with the https://www.uptodate.com/contents/cardiac-implantable-electronic-devices-patient-follow-up/print 16/19 7/6/23, 10:48 AM Cardiac implantable electronic devices: Patient follow-up - UpToDate permission of Elsevier Inc. All rights reserved. Graphic 108755 Version 1.0 https://www.uptodate.com/contents/cardiac-implantable-electronic-devices-patient-follow-up/print 17/19 7/6/23, 10:48 AM Cardiac implantable electronic devices: Patient follow-up - UpToDate Minimum frequency of cardiac implantable electronic device (CIED) follow- up Type Frequency Delivery method Immediate post-implant check Within 72 hours In person Early post-implant check 2 to 12 weeks In person Routine PPM/CRT-PPM check Every 3 to 12 months In person or remote Routine ICD/CRT-D Every 3 to 6 months In person or remote Following one ICD/CRT-D shock Within 24 to 48 hours In person or remote Following >1 ICD/CRT-D shocks Immediately In person Any CIED until signs of battery depletion Annually In person Any CIED following signs of battery depletion Every 1 to 3 months In person or remote CIED: cardiac implantable electronic device; CRT: cardiac resynchronization therapy; ICD: implantable cardioverter-defibrillator; PPM: permanent pacemaker. Adapted from: Wilko BL, Auricchio A, Brugada J, et al. HRS/EHRA expert consensus on the monitoring of cardiovascular implantable electronic devices (CIEDs): description of techniques, indications, personnel, frequency and ethical considerations. Heart Rhythm 2008; 5:907. Graphic 91502 Version 3.0 https://www.uptodate.com/contents/cardiac-implantable-electronic-devices-patient-follow-up/print 18/19 7/6/23, 10:48 AM Cardiac implantable electronic devices: Patient follow-up - UpToDate Contributor Disclosures Bradley P Knight, MD, FACC Grant/Research/Clinical Trial Support: Abbott [Electrophysiology]; Atricure [Electrophysiology]; Biosense Webster [Electrophysiology]; Biotronik [Electrophysiology]; Boston Scientific [Electrophysiology]; BSCI [Electrophysiology]; MDT [Electrophysiology]; Philips [Electrophysiology]. Consultant/Advisory Boards: Abbott [Electrophysiology]; Atricure [Electrophysiology]; Biosense Webster [Electrophysiology]; Biotronik [Electrophysiology]; Boston Scientific [Electrophysiology]; BSCI [Electrophysiology]; CVRx [Heart failure]; MDT [Electrophysiology]; Philips [Electrophysiology]; Sanofi [Arrhythmias]. Speaker's Bureau: Abbott [Electrophysiology]; Biosense Webster [Electrophysiology]; Biotronik [Electrophysiology]; Boston Scientific [Transeptal catheterization]; BSCI [Electrophysiology]; MDT [Electrophysiology]. All of the relevant financial relationships listed have been mitigated. Samuel L vy, MD No relevant financial relationship(s) with ineligible companies to disclose. Nisha Parikh, MD, MPH No relevant financial relationship(s) with ineligible companies to disclose. Contributor disclosures are reviewed for conflicts of interest by the editorial group. When found, these are addressed by vetting through a multi-level review process, and through requirements for references to be provided to support the content. Appropriately referenced content is required of all authors and must conform to UpToDate standards of evidence. Conflict of interest policy https://www.uptodate.com/contents/cardiac-implantable-electronic-devices-patient-follow-up/print 19/19