Patients suffering from heart failure or ventricular fibrillation can have greater peace of mind about their health condition thanks to a new technology that allows remote wireless monitoring of implanted cardiac devices (ICDs). The remote monitoring technology allows physicians to obtain diagnostic information from the device's memory via a password-protected, secure site. This capability can reduce the number of in-office visits a patient needs, which is more convenient for the patients and is a time-saver for physicians. Patients transmit data over a telephone line using a small piece of equipment on their bedside table. Once the device is programmed, data is uploaded automatically and no patient interaction is necessary. Tracy McNulty, spokesperson for Medtronic, said these devices can detect life-threatening episodes of atrial fibrillation or fluid buildup in the chest. "The devices also can be programmed by the physician to send alerts when a patient's condition changes," McNulty said. "Depending on the physician's preference, he or she can receive this information by voice mail or pager and can follow up with the patient immediately." Dave Knutson of Boston Scientific said their LATITUDE® patient management system has the same capabilities and can also monitor blood pressure and weight. He said the technology has the potential to reduce hospitalizations and to make collaborative care more efficient. "Using our LATITUDE system, the cardiologist and the electrophysiologist can pull up patient records from different offices. The doctors don't have to call one another to get an update on a patient's condition." Russell Reeves, MD of CardioVascular Associates at Trinity Medical Center has used the Medtronic CareLink® Network for about six months and called the technology "an incremental improvement that will be developed further over time." Reeves added that as the capabilities evolve, they will allow more improved and efficient patient care. The technology is already assisting doctors with routine monitoring of patients. "By checking an ICD over the telephone, the Medtronic system gives us enough information to be reasonably assured that the device is stable and functioning okay," he said. Reeves added that remote monitoring is helping doctors evaluate "events" such as a shock from the ICD for patients who can't easily come into the physician's office. "When a patient gets a shock and is otherwise doing okay, we check to make sure the device is functioning correctly and that the shock was appropriate," Reeves said. "It is frequently helpful for distant patients to get the device checked over the phone, saving them a trip to the doctor's office." Sanjeev Hasabnis, DO, of CardioVascular Associates at Brookwood Medical Center, has used Boston Scientific's LATITUDE system for about a year. He, too, gives accolades to the technology for efficiency of retrieving patient and device information via the Internet and the ability to give a patient a basic evaluation without an office visit. "As we get better versed, we'll be able to get to yearly office visits," he said. Hasabnis said besides the device therapy, the biggest benefit of the system is the weight monitoring capability, which can alert a doctor of congestive heart failure. "It gives us the opportunity to break the cycle of congestive heart failure without the patient having to come into the office with an 'episode,'" he said. Knutson said Boston Scientific continues to expand the capabilities of its LATITUDE system and is currently conducting trials in Philadelphia and Seattle of a new electronic medical record system that will allow physicians to see patient files from the past three years, permitting doctors to view a patient's history via the Internet. Medtronic is also updating its system to more effectively measure patients' volume status, according to Reeves. When this capability is approved by the Federal Drug Administration, the system will measure the electrical resistance of fluid in a patient's lungs. "Early information indicates that the signal from the device may occur before the patient becomes symptomatic," Reeves said. "This would allow for medication adjustment to hopefully avoid hospitalization." The potential for additional uses of remote monitoring technology are exciting, but for now the possibility for early intervention offers assurance to patients and their families.