To the Editor,

A remote cardiac support system (RCSS) has been recently suggested as a novel technology primarily used in cardiac device implantation and electrophysiological study.¹ In this system, an encrypted connection over the internet is established between the health staff using smart glasses and a technician in the pacemaker company center. Implantation and programming of pacemakers can be performed quickly through RCSS, owing to its significant potential to offer high-resolution images. Therefore, harnessing this system might potentially eliminate any hindrance associated with external circumstances, such as transportation and climate conditions, leading to the timely initiation of interventional procedures. Moreover, as a cost-effective strategy, it might reduce hospitalization and transportation expenses and, consequently, might potentially lead to the improvement of other medical facilities including hospital pacemaker supply, etc.

 In this context, we have successfully performed the first intervention via RCSS in our university hospital where pacemaker implantations have been performed quite often. On the contrary, our center is located relatively remote from pacemaker companies, potentially indicating a greater need for such systems. Within 1 day, three interventions (1 dual-chamber rate-modulated pacemaker, 1 single-chamber implantable cardioverter-defibrillator, and 1 cardiac resynchronization therapy defibrillator implantation) were performed using smart glasses and programming in our center (Figure 1). Communication with standard internet speed of >10 MPS wireless was fully provided. Importantly, no negative feedback was heard from the operators and patients. Specifically, patients were highly satisfied with the rapid treatment planning. In this regard, we expect RCSS to become a widely recognized phenomenon in our country because of its significant advantages.