Implementation of remote monitoring strategies to improve chronic heart failure management

Abstract

Purpose of review The goal of this review is to describe the current evidence available for remote monitoring devices available for patients with chronic heart failure, and also detail practical clinical recommendations for implementing these tools in daily clinical practice. Recent findings Several devices ranging from sophisticated multiparametric algorithms in defibrillators, implantable pulmonary artery pressure sensors, and wearable devices to measure thoracic impedance can be utilized as important adjunctive tools to reduce the risk of heart failure hospitalization in patients with chronic heart failure. Pulmonary artery pressure sensors provide the most granular data regarding hemodynamic status, while alerts from wearable devices for thoracic impedance and defibrillator-based algorithms increase the likelihood of worsening clinical status while also having high negative predictive value when values are within normal range. Summary Multiple device-based monitoring strategies are available to reduce longitudinal risk in patients with chronic heart failure. Further studies are needed to best understand a practical pathway to integrate multiple signals of data for early clinical decompensation risk prediction Video abstract: http://links.lww.com/HCO/A95.

A Lower Remote Dielectric Sensing Value Was Associated with Hypovolemia and Worse Clinical Outcomes

“…Right heart catheterization is the gold standard for quantifying intracardiac pressures, though it is important to consider that intracardiac pressure measurements are not always representative of pulmonary congestion. It is also important to consider that routine application of invasive hemodynamic assessment is not practical due to resource utilization, cost, and invasiveness [ 8 ].…”