OBJECTIVES: Develop a probabilistic and comparative cost analysis, from patient and hospital perspective of Remote vs. In-Office monitoring in patients with cardiac rhythm devices METHODS: An economic interactive probabilistic cost model was built in excel. The cost variables were identified with patient and hospital KOL surveys regarding timing and cost related issues. Secondary data from a 2012 Heart Rhythm Society study was used. Medical outpatient direct costs were taken from the Clinic. Uncertainty adjustment was made to probabilistic variables. Beta, normal and Gamma distributions were used for probabilistic, time and cost variables. Min and max ranges were used when standard deviations were no available. After deterministic results, Monte Carlo simulation with 1000 iterations was done. The main statistic results obtained were deterministic and probabilistic average with their corresponding confident intervals, probabilistic density function and cumulative density function. RESULTS: Probabilistic patient total average costs for Remote monitoring was US$18.5 (95% CI US$2.0 – US$152.6) in contrast to In-office monitoring with US$ 51.41 (95% CI US$ 5.0 – 386.7  US$), which represents a 64% cost reduction and a narrow confident interval. Probabilistic outpatient hospital total average cost for Remote monitoring was US$33.1 (95% CI US$31 – US$35.2) in contrast to In-Office monitoring with US$ 63.9 (95% CI US$ 59.3 –US$68.8), which represents a 48% cost reduction and a narrow confident interval. In the cumulative distribution function for total patient cost and for total outpatient hospital cost, the probability for Remote monitoring to have a lower cost than each considered threshold was higher than In-Office interrogation for all values. CONCLUSIONS: This cost model allows comparing the probabilistic cost distribution of the Remote vs. In-Office Interrogation cardiac rhythm devices. The Remote monitoring costs are lower for the patient and for the ambulatory hospital services and are more predictable than In-Office interrogation costs.