Intensive Follow-up via Remote Monitoring of Implantable Cardioverter Defibrillators in people with severe left ventricular dysfunction.

Standard Remote Monitoring: Each site selected to participate in the study is currently participating in remote monitoring. Sites will continue undertaking remote monitoring. Clinic staff will access RM data via individual device vendor internet-based interfaces. Response to RM data transmissions will be at the discretion of site investigators. Managed Remote Monitoring: Managed remote monitoring will occur via a cloud-based, automated, vendor-neutral software system with round-the-clock (including overnight, weekend, public holiday) immediate processing of device alerts and scheduled downloads by trained technicians. Processed device data will be rapidly forwarded to investigational sites. Investigational sites will access processed data, triaged alerts, and updated patient charts via a single, secure internet-based interface including all device vendors. The system will include direct contact made with patients in the event of device transmission failure. All patients will receive a transmitter to plug in at home next to the bed. Overnight, the transmitter communicates with the ICF and sends messages to the clinic. The participant will not be responsible for sending transmissions as the process is automated. The total duration of the intervention is 24 months. Those patients randomised to the intensively managed remote monitoring group, or the standard remote monitoring group, will have any data transmitted to the clinic reviewed, and will be contacted in the event of a problem, or in the event that the clinic has not received communication from your ICD for 7 days. Those patients randomised to clinic follow-up without remote monitoring will have their ICD checked every 6 months during their clinic visit.