Discussion
From the safety point of view, similar survival rates and safety outcomes have been demonstrated when RM was compared to in-person follow-up appointments in randomized clinical trials and metanalysis2-5. Moreover, it is well known that RM allows a prompt and quicker detection of arrhythmias and device malfunctions5. During the study period, we observed 213 clinical events that triggered an urgent manual transmission and/or required physician’s intervention (table 1), successfully resolved over the following 24 h. None of the 1676 patients presented to the emergency room with a problem that went unnoticed by the RM system. However, the safe profile of RM had to be balanced against the high number of transmissions that our dedicated team received and that required daily evaluation (8514 RM transmissions/year).