Monitoring capabilities of cardiac rhythm management devices

Since the advent of the first generation pacemakers, solely providing rate support, we have witnessed a technological outburst in the type and complexity of implantable devices. The introduction of implantable cardioverter defibrillators and later of cardiac resynchronization therapy devices enriched our therapeutic arsenal for the management of patients with heart failure and/or high risk of sudden cardiac death. In addition, during the last decade, newer generation cardiac rhythm management devices (CRMs) have been capable to provide a continuously expanding pool of diagnostic information derived by novel monitoring capabilities. Although at present the clinical role of this information is undervalued, it is evident that the clinical exploitation of data derived by CRMs may transform the standards of care for our patients by providing timely applied individualized diagnosis and treatment. In this context, even in the absence of solid data supporting the use of this information in everyday clinical practice, improving our familiarity with currently available monitoring algorithms is a perquisite for the electrophysiologist who keeps in pace with the rapidly evolving technologies of CRMs and is prepared for their future role on clinical practice.