| Summary: | The Centers for Medicare & Medicaid Services (CMS) requested that the Agency for Healthcare Research and Quality (AHRQ) commission an evidence report to evaluate remote cardiac monitoring devices. Accordingly, on November 9, 2006, AHRQ, in consultation with CMS and ECRI Institute, issued a Statement of Work (SOW) contracting ECRI Institute to prepare an evidence report on this topic. Remote cardiac monitoring technologies allow home electrocardiographic (ECG) monitoring of patients with suspected cardiac arrhythmias or at risk for developing arrhythmias. Two major categories of remote cardiac monitoring devices are evaluated in this report. The first category consists of patient- or event-activated devices, which include externally-worn pre-symptom memory loop recorders (attended and unattended), implantable/insertable pre-symptom memory loop recorders (attended and unattended), and post-symptom patient-activated recorders. The second category comprises real-time continuous attended cardiac monitoring systems. These devices are described in detail under Evidence Synthesis, Key Question 1. Continuous unattended cardiac monitoring (e.g., Holter monitoring) is beyond the scope of this report. Pre-hospital (in ambulance) monitoring and transmission, as well as monitoring solely for the purpose of detecting device failure, are also beyond the scope of this report. The patient population of interest in this report consists of patients with suspected cardiac arrhythmias manifesting through symptoms such as syncope (transient loss of consciousness), presyncope, dizziness, palpitations, and other symptoms that could be attributed to arrhythmia. Patients with life-threatening arrhythmias would not be considered candidates for these technologies. Patients with primary non-cardiac diagnoses (e.g., epilepsy) are beyond the scope of this report
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