GoTo Telemed, the nation's leading integrated telehealth ecosystem serving over 10 million patients nationwide, today announced the launch of its Post‑MI Arrhythmia Follow‑up Protocol, a comprehensive virtual care service designed to address the full spectrum of post‑myocardial infarction arrhythmia risk through structured remote monitoring, early arrhythmia detection, and evidence-based secondary prevention. Delivered by a network of cardiologists, electrophysiologists, cardiac nurses, and rehabilitation specialists, this program brings expert, continuous care directly to heart attack survivors across the country.

Sudden cardiac death in the setting of an acute myocardial infarction (MI) is most frequently the result of a ventricular tachyarrhythmia. The appearance of a sustained ventricular tachyarrhythmia following an MI, such as ventricular tachycardia (VT) or ventricular fibrillation (VF), may be the harbinger of ongoing myocardial ischemia, the development of proarrhythmic myocardial scar tissue, elevated sympathetic tone, or an electrolyte disturbance. In‑hospital mortality approaches 20 percent or more in patients who develop VT or VF following an MI, and all patients with a prior MI have an elevated risk of malignant arrhythmias, with reduced left ventricular ejection fraction (LVEF) being the most prominent risk stratifier.

“A heart attack is not the end of the journey – it is the beginning of a lifelong process of risk management and surveillance,” said a GoTo Telemed spokesperson. “Our Post‑MI Arrhythmia Follow‑up Protocol integrates the latest 2025 ACC/AHA guidelines with modern remote monitoring technology to provide heart attack survivors with continuous arrhythmia detection, structured medication management, and coordinated rehabilitation. Through home ECG monitoring, remote vital sign tracking, and virtual cardiology visits, we are extending the reach of expert arrhythmia care beyond the hospital walls.”

Guideline-Aligned Risk Stratification and Remote Monitoring

The protocol is anchored in the 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes, which provides evidence‑based recommendations for long‑term management and secondary prevention. For arrhythmia surveillance, the guideline emphasizes structured follow‑up for all patients post‑MI, with intensity tailored to LVEF and the presence of ventricular ectopy.

The American College of Cardiology (ACC) has also released the ACC Remote Patient Management Workbook, which breaks down remote patient monitoring (RPM) applications for specific cardiovascular conditions, including post‑MI care, heart failure management, atrial fibrillation monitoring, and cardiac rehabilitation. The workbook addresses key implementation considerations, including data overload, EHR integration, and reimbursement complexities, providing a realistic picture of RPM implementation.

GoTo Telemed's post‑MI protocol incorporates the following RPM capabilities:

RPM Component Clinical Application Supporting Evidence
Home ECG Telemonitoring Continuous or intermittent ECG recording for detection of paroxysmal arrhythmias Home ECG telemonitoring after acute MI is currently being evaluated in randomized controlled trials to assess its impact on healthcare utilization
Wearable Patch ECG Devices Adhesive, matchbox‑sized monitors (e.g., Philips ePatch) that can detect potential cardiac arrhythmias such as AF and angina; allow monitoring for longer periods and can find up to 2.5x more clinically relevant heart rhythm disorders compared to traditional Holter monitoring Zio® long‑term continuous monitoring (LTCM) captures up to 14 days of continuous, uninterrupted data, and studies show that short‑term (24–48‑hour) monitoring can miss actionable arrhythmias – even in patients reporting daily symptoms
Cardiovascular Digital Twins Virtual modeling of patient‑specific cardiac anatomy and electrophysiology for prediction of arrhythmia risk “Wearables and implantable devices have fundamentally changed our ability to capture rhythm disturbances outside the clinic, and they have clearly shown that longitudinal, real‑world monitoring can meaningfully impact outcomes.”
Bluetooth Vital Sign Monitoring Daily tracking of heart rate, blood pressure, weight, and oxygen saturation Integration with the patient's electronic health record; abnormal values trigger automated alerts for the care team
Remote ICD and Device Management

The protocol aligns with current guidelines for implantable cardioverter‑defibrillator (ICD) placement:

ICD implantation is recommended for patients with prior MI and reduced LVEF (≤30%), with implantation delayed until at least 40 days post‑MI (Class I recommendation).

For patients with an LVEF of 30%–35% on optimal medical therapy, ICD placement is also appropriate under the 2025 Appropriate Use Criteria.

For patients awaiting ICD implantation or those with a temporary contraindication, wearable cardioverter‑defibrillators (WCDs) can be prescribed and monitored remotely.

Remote Cardiac Rehabilitation and Lifestyle Monitoring

Secondary prevention, including cardiac rehabilitation, is reinforced in the 2025 ACC/AHA guideline to reduce long‑term cardiovascular risks. GoTo Telemed's protocol integrates:

Home‑based cardiac rehabilitation with remote ECG monitoring, which has been shown to be safe and feasible for patients after cardiac procedures.

Structured exercise prescriptions delivered via video sessions with cardiac rehabilitation specialists.

Digital medication adherence tools for antiplatelet therapy (DAPT for at least 12 months in low‑bleeding‑risk patients), high‑intensity statins, and beta‑blockers.

Comprehensive Program Components

Protocol Component Description
Arrhythmia Risk Stratification Comprehensive assessment at discharge including LVEF measurement (echocardiography or CMR), 24–48‑hour Holter monitoring (or longer if clinically indicated), and evaluation of PVC burden and non‑sustained VT. For patients with LVEF ≥40%, the PRESERVE EF study provides risk stratification guidance.
Remote ECG Monitoring Protocol For high‑risk patients (LVEF ≤40%, significant PVCs, NSVT): wearable patch ECG for 14–30 days post‑discharge; monthly 48‑hour monitoring thereafter for 6 months. For lower‑risk patients: symptom‑triggered or periodic 48‑hour monitoring. All data transmitted to GoTo Telemed's secure platform and reviewed by the electrophysiology team.
Device Management Coordination of ICD implantation for eligible patients; remote interrogation of ICDs and pacemakers; WCD prescription and monitoring for patients awaiting ICD or with temporary contraindications.
Virtual Cardiology Follow‑up Scheduled video visits at 2 weeks, 1 month, 3 months, 6 months, and 1 year post‑discharge; medication titration; review of remote monitoring data; adjustment of antiarrhythmic therapy.
Cardiac Rehabilitation 12‑week home‑based program with remote ECG monitoring, exercise sessions, dietary counseling, and risk factor modification.
Secondary Prevention Medication Management Automated adherence monitoring for DAPT, statins, beta‑blockers, ACE inhibitors/ARBs. Guideline‑recommended lipid testing 4–8 weeks after statin initiation or dose adjustment.
Patient and Caregiver Education Resources on arrhythmia symptom recognition, medication adherence, activity precautions, and when to seek urgent care.
Clinical Evidence for Remote Post‑MI Monitoring

A study published in Telemedicine and e‑Health found that cardiovascular RPM led to a 65% decrease in hospital admissions and an 85% reduction in hospital observations, with a 173% return on investment.

The ACC RPM Workbook notes that remote monitoring “can lead to significant improvements in patient care and healthcare efficiency”.

Real‑world data from over 1.1 million patients demonstrated that short‑term monitoring (24–48 hours) can miss actionable arrhythmias, underscoring the value of longer‑duration home monitoring.

Integration Within GoTo Telemed's Comprehensive Cardiac Ecosystem

The Post‑MI Arrhythmia Follow‑up Protocol operates as a fully integrated component of GoTo Telemed's unified telehealth platform:

Unified Health Record: All remote monitoring data, ECG recordings, device interrogations, and clinical notes are consolidated in the patient's lifetime electronic health record, accessible to cardiologists, electrophysiologists, and primary care providers.

Automated Alert System: Clinicians receive real‑time alerts for significant arrhythmias (sustained VT, VF, high‑grade AV block), rapid heart rate changes, or concerning symptom reports.

Seamless Care Coordination: Warm handoffs to electrophysiology for ICD evaluation, to cardiac rehabilitation services, and to primary care for ongoing risk factor management.

Patient Portal Access: Patients view their monitoring results, access educational materials, complete symptom diaries, and communicate with their care team through GoTo Telemed's secure portal.

Media Contact:
GoTo Telemed Media Relations
[email protected]
(660) 628-1660
https://gototelemed.com/