In the TeleGuard trial, 1500 patients with established coronary artery disease (CAD) were recruited and randomized to control or intervention groups. Patients in the intervention group were equipped with a 12-lead event recorder and could contact a call centre and transmit an ECG whenever they wished. In a 12-month study, the composite endpoint (all-cause mortality, myocardial infarction, re-hospitalization or re-vascularization) was seen in 40% of the intervention patients and in 38% of the control patients. In both groups, approximately 40% were re-hospitalized. In total, 73 patients experienced re-vascularization, 75 showed an infarction and 33 died. Equipping CAD patients with a 12-lead ECG device and providing a telemedicine centre with 24-hour availability did not decrease risk for the composite endpoint (re-hospitalization, re-vascularization, (subsequent) myocardial infarction and/or death). It is likely that the clinical pathway used in the telemedicine centre led to an increased hospital admission rate in the intervention group.