Technology and Device Management

Journal Articles: This is the second in a series of Heart Rhythm quarterly features, highlighting science relevant to quality improvement. The focus of this feature is the prevention of cardiac implantable electronic device infection.

Journal Articles: Remote monitoring of pediatric cardiac implantable electronic devices (CIEDs) has become an important tool in outpatient management. Recent guidelines (Shah et al, JACC Clin Electrophysiol 2021;7:1437, PMID 34794667) from the Pediatric and Congenital Electrophysiology Society (PACES) have recommended remote monitoring of CIEDs every 3–12 months for pacemakers and every 3–6 months for implantable cardioverter-defibrillators, with an increase in frequency when the device is approaching elective replacement indicators. Compared with their adult counterparts, pediatric and adult patients with congenital heart disease have a higher frequency of epicardial devices that carry an elevated risk of lead fracture, which may lead to adverse outcomes, especially in pacemaker-dependent patients (Post et al, Neth Heart J 2011;19:331, PMID 21567217). CIED remote transmission remains a vital modality to ensure safe monitoring and assessment of temporal CIED trends, especially battery longevity and lead functionality. Furthermore, advances in remote monitoring foster a sense of disease-specific knowledge, improved self-management, and shared decision making (Walker et al, Int J Med Inform 2019;124:78, PMID 30784430).