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The use of the Web for medical application areas seems to be an attractive solution for many problems. Nowadays the Web becomes a standardized infrastructure for giving access to advanced telemedicine applications. Such web services provide accessibility and usability advantages for patients and physician. This paper presents a solution for a pacemaker followup system as a telemedicine application. It presents the general architectural and technical issues of the web server, the database and the signal processing unit. A first clinical pilot trial has been performed which indicates the efficiency of the system The evaluation of 36 examinations indicates that in approximately 80% of cases a hospital visit of the patients is not necessary.