Follow-Up

Follow-up of implantable cardiac devices is critical from the standpoint of patient safety, patient satisfaction, device optimization, the patient's physical and psychologic well-being, and often for chronic disease management. It is a requirement that arrangements be made for chronic surveillance at the time of device implantation. Routine approaches for frequency of follow-up, remote-monitoring or trans-telephonic surveillance, periodic in-clinic evaluation should all be established. Algorithms for in-clinic interrogation and programming as well as guidelines for troubleshooting should be developed and followed as part of device clinic follow-up. Patient education is critical and although it may be considered largely an activity to be completed at the time of device implantation, ongoing education is often required. Patient management in the presence of a device advisory or recall must be understood and is often facilitated by a standard approach. Psychologic issues that arise related to implantable devices should also be anticipated in the follow-up period and qualified personnel be available to counsel and educate patients on these issues.