This section is intended for people who have, or are about to receive, an implantable cardioverter defibrillator (ICD) or pacemaker that has a remote monitoring capability. Routine care of patients with pacemakers and ICDs involves regular attendances at the hospital to make sure that all is well. A short-range radio signal is used to communicate with the device through the skin. These visits are usually needed between one and four times a year. Recent developments in wireless communication with implantable devices have enabled the collection of data at home that is then passed to the hospital over the internet. In some cases, it is possible for routine checks on the device to be done remotely, without the need for a visit to the hospital.
For more general information on the function and implantation of ICDs and pacemakers, please click on the links in this sentence.
The information here should be used in addition to that provided by your clinicians. If you have any questions about any of the information in this booklet, please ask your nurse, doctor or cardiac physiologist.
Remote monitoring enables the monitoring your heart and implanted device while you are at home, and “remote” from the care-team at your hospital. Remote monitoring pacemakers and ICDs are equipped with a special transmitter. Using an integrated aerial, the implant automatically sends medical and technical information from your heart, to the clinicians who are treating you. This allows them to monitor accurate and current clinical information at any time – not just when you are at the hospital. Remote monitoring will not replace the first visit after the device is implanted, which is important to check that the wound is well-healed, and you may still need to attend the clinic once a year. However, if all is well, it may take over the routine checks on your device, which relieves you and your care-team from having to attend to these checks at the hospital.
Information is typically sent from your device via a home receiving unit that uses the internet to connect with the hospital. The information received at the centre will allow them to look at any changes that might have occurred either with your heart rhythm or with the implant. Depending on which company made your device, the receiving unit might look like a large mobile phone or can be a box that you plug into a telephone line. Your implanting centre will provide you with all the information you need to use it correctly.
To maintain confidentiality, the data collected from your device is encrypted and then sent automatically to the hospital. The clinic staff are then able to view and evaluate the data on a secure internet site.
Unfortunately not all devices have the option of remote monitoring, and not all centres have adopted it. If your implanting centre is using devices with this facility, you may be offered the opportunity to have this function.
With remote monitoring, or remote follow-up, technology your clinicians can be kept up-to-date on your device and your heart. This enables them to schedule your hospital appointments or your remote follow-up appointments as part of routine follow up.
Should you need to contact your follow up clinic because you are experiencing symptoms that cause you concern, they can evaluate your cardiac condition remotely and decide what course of action, if any, to take.
You should contact your follow-up clinic if you are travelling abroad, as some of the remote monitoring systems use different telephone networks and so may not function in some countries. You may also choose not to take your remote monitor on holiday with you.
Yes, remote monitoring/follow-up technology has been in use since 2000 and has been proven to be safe, secure and reliable.
Do I still need to attend the usual follow-up clinics?
You may not need to attend as frequently as you do currently. However, you will still need to attend the follow-up clinic if any changes to your programmed settings are required or to perform certain measurements that may be necessary.
The interval between follow-ups is dependent on many factors, including your individual condition and the device implanted. It is very important that you attend all follow-up clinic appointments that may be recommended by the doctors, arrhythmia nurses and cardiac physiologists caring for you.
Where should I place my receiver unit?
Your implanting centre will give full instructions on where to put your receiver unit and how to send any messages.
Do I need any other equipment for remote monitoring / remote follow-up?
If you and your pacing/ICD clinic staff decide remote monitoring or remote follow- up may be beneficial to you, then it is possible that you can be enrolled today, or that you can have a device implanted with this capability. The aerial is hidden inside the device, therefore the implant will look and feel like any other.
In order to send the signals from your ICD or pacemaker you will need a special transmitting device. This may look like a mobile phone or a small box which you will need to plug into your telephone line.
Is there a risk the encrypted data will be mixed up?
No. Your data cannot be mixed up during transmission. Your implant and transmitter are clearly allocated to each other using their respective serial numbers.
Is my data safe from unauthorized persons?
Yes. Your cardiac physiologist/arrhythmia nurse/doctor views your data via the internet through a secured connection. The server and all systems have been CE certified and comply with the UK data protection act.
Will I be able to access the data myself?
No. The information is only available to the medical team treating you; security measures ensure it is not accessible to anyone else.
Is there a danger from radiation during data transmission?
No. The implant transmits data with an extremely low power on a frequency specially allocated to medical devices, so there is no danger.