Contribution of Automatic Wireless Remote Monitoring to the Early Detection of Arrhythmic Events

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Background: Automatic daily transmission of data from cardiac resynchronization therapy device with defibrillator (CRT-D) enables the early detection of arrhythmic events and minimizes the risk of adverse clinical events. Methods: From March 2003, we started to introduce the remote monitoring system with automatic and wireless data transmission capability to 18 patients who underwent implantation of CRT-D or implantable cardioverter-defibrillator. Arrhythmic events were defined as detection of ventricular tachycardia (VT) or ventricular fibrillation (VF) and any activation of device therapy to those arrhythmias whether appropriate or inappropriate. Results: We could receive informed consent from all 18 patients. Arrhythmic events were detected in two patients (11%). One event was inappropriate detection of VF due to T-wave oversensing 16 days after introduction of remote monitoring. The other event was appropriate anti-tachyarrhythmic pacing to sustained VT 6 days after introduction. We could contact both patients immediately and successfully solve the problems. Conclusions: Automatic wireless remote monitoring allowed the early detection of lethal arrhythmic events without requiring any tasks for patients. It results in good patients, adherence and immediate medical solution.