Remote monitoring of cardiovascular implantable electronic devices in Canada: Survey of patients and device healthcare professionals

Abstract Background Remote monitoring is used to supplement in-clinic follow-up for patients with cardiac implantable electronic devices (CIEDs) every 6 to 12 months. There is a need to optimize remote management for CIEDs given consistent increases in CIED implants over the last decade. Objective To investigate real and perceived barriers to the use of remote patient management strategies in Canada and to better understand how remote models of care can be optimized. Methods We surveyed 512 CIED patients and practitioners in 22 device clinics in Canada. Results Device clinic surveys highlighted significant variation and inconsistency in follow-up care for in-clinic and remote visits across and within clinics. This survey found that funding policies and management of additional workflow are barriers to optimal use and uptake. Despite this, device clinics perceive remote follow-up as a valuable resource and an efficient way to manage patient follow-up. Patients were broadly satisfied with their CIED follow-up care but identified barriers related to coordination of care, visit logistics, and information needs. Views varied as a function of clinical or socio-demographic characteristics. Most patients (n=228; 91%) expressed a desire to receive a phone call from their device clinic after a remote transmission has been received. Conclusion Lack of a unified, guideline-supported approach to follow-up after CIED implant, and discrepant funding policies across jurisdictions, are significant barriers to the use of remote patient management strategies in Canada. Efforts to increase or expand use of remote follow-up must recognize these barriers and the needs of specific sub-groups of patients.