The number of follow-up visits for patients with a cardiovascular implantable electronic device (CIED) exceeds 5.8 million visits each year, and as more CIEDs are implanted that number will continue to increase. In 2007 alone, nearly one million patients in North America and more than 800,000 in Europe received a CIED, such as a pacemaker, implantable cardioverter defibrillator or cardiac resynchronization therapy device. These devices provide ongoing therapy for patients, but throughout the patient’s lifespan therapy requires monitoring and adjustments. This new consensus statement [1] offers guidance on the management of CIEDs from implantation until explantation or the patient’s death.

To ensure that these life-saving devices are managed properly and patients receive the best possible care, the Heart Rhythm Society and the European Heart Rhythm Association have prepared this joint consensus document to bring together an international panel of experts in order to comprehensively address all issues related to device management and follow-up. This panel agreed that device monitoring should be handled by professionals specially trained in the field, and also issued a request for the device industry, health care institutions and physician practices to provide the necessary infrastructure that will ensure patient care is safe and effective.

The new consensus statement offers guidance on a range of issues including:
• Factors that determine the type and frequency of device follow-up
• Content requirements for both in person and remote monitoring
• Data management considerations including patient confidentiality and data security
• Remote management strategies
• Considerations for the development of a global device registry
• Roles and responsibilities for physicians, allied professionals, manufacturers and regulatory agencies
• Patient education and responsibilities
• Ethical considerations, including CIED management in dying patients
• Reimbursement issues

[1] Wilkoff BL, Auricchio A, Brugada J, et al. HRS/EHRA Expert Consensus on the Monitoring of Cardiovascular Implantable Electronic Devices
(CIED): Description of Techniques, Indications, Personnel, Frequency and Ethical Considerations. Europace 2008; in press