Checking patients with pacemakers or defibrillators normally requires regular clinic visits. But computer technology and the internet allow continuous remote monitoring of heart rhythms, while patients remain at home.

Leading the project is Dr Edward Barin, a specialist in arrhythmias and cardiac devices.

Aims

This collaborative study aims to assess the value and benefits of remote monitoring of pacemakers and defibrillators implanted under the skin to regulate a variety of abnormal heart beats (arrhythmias). It also looks at the potential to:

• improve patients' adherence to treatment programs, rehabilitation and exercise
• save hospital costs by reducing clinical visits. 

The study

Dr Barin supervises the Cardiac Rhythm Management Unit based at the Department of Cardiology, Royal North Shore Hospital. He hopes to find out whether the monitoring system provides useful and timely alerts to doctors about problems, beyond traditional clinic-based methods.

Based on mobile phone technology, the novel smartphone was developed at the University of Technology, Sydney. In 2008 it was successfully trialled in patients at Royal North Shore Hospital, and findings confirmed the reliability, accuracy and safety of the system. As a result, pacemakers and other implanted devices are increasingly being monitored in this way.

The unique phone software has attracted international attention and may form the basis of further trials in patients on cardiac rehabilitation programs.

Benefits of remote monitoring

The automated system may be especially useful for patients unable to attend clinics because of distance, poor health or inadequate transport, or for those who plan to travel to remote areas or overseas.

'Sometimes people wait for hours for their clinic appointment, and relatives have to take time off work. But once you've inserted these pacemakers, you can just send the patient off,' says Dr Barin. 'We're doing the groundwork for the future. There will be more pacemakers and older people, and this method could reduce the burden on health centres.'

Several major pacemaker companies such as Biotronik, St Jude Medical, Boston Scientific and Medtronic now produce remote monitoring systems for their devices. They are now seen as a standard of care for centres in Europe and the United States.