Abstract
BACKGROUND: Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) reduces health care visits and improves clinical outcomes, but its use and service models are poorly characterized. OBJECTIVE: This study aimed to examine the current landscape of CIED RM in Australia and New Zealand, including the prevalence of CIED and RM use, care models for RM data management, and infrastructure and resource requirements. METHODS: A cross-sectional study was conducted using surveys of CIED clinics in Australia and New Zealand and analysis of deidentified CIED industry data. Data were obtained from public and private clinics and all 5 major CIED manufacturers. RESULTS: Operational data were obtained from 50 clinics and implant/RM distribution data from all 5 manufacturers. From 2019 to 2023, total CIED implantations increased by 10.2% (125.9-138.8 per 100,000 people), whereas RM transmitter distribution rose 55.8% (75.5-117.6 per 100,000 people). In 2023, RM use was highest in remote (88.4%) and rural regions (85.3%) compared with regional (73.1%) and metropolitan (80.3%) areas. From survey data, the median clinic patient load was 1303 patients (interquartile range 1820) per year. On average, 30.2% of clinic workload (standard deviation 21.8%) was dedicated to managing RM alerts, primarily by cardiac physiologists (90.5%). The mean interval between scheduled in-person CIED follow-ups was longer for RM patients than non-RM patients (10.0 vs 7.2 months; P < .001). CONCLUSION: This study provides the first comprehensive analysis of CIED RM service use, offering insights to inform future RM care models and the development of other virtual care systems using remote patient data.