Remote monitoring of chronic heart failure patients: invasive versus non-invasive tools for optimising patient management

Abstract

Exacerbations of chronic heart failure (HF) with the necessity for hospitalisation impact hospital resources significantly. Despite all of the achievements in medical management and non-pharmacological therapy that improve the outcome in HF, new strategies are needed to prevent HF-related hospitalisations by keeping stable HF patients out of the hospital and focusing resources on unstable HF patients. Remote monitoring of these patients could provide the physicians with an additional tool to intervene adequately and promptly. Results of telemonitoring to date are inconsistent, especially those of telemonitoring with traditional non-haemodynamic parameters. Recently, the CardioMEMS device (Abbott Inc., Atlanta, GA, USA), an implantable haemodynamic remote monitoring sensor, has shown promising results in preventing HF-related hospitalisations in chronic HF patients hospitalised in the previous year and in New York Heart Association functional class III in the United States. This review provides an overview of the available evidence on remote monitoring in chronic HF patients and future perspectives for the efficacy and cost-effectiveness of these strategies.

Wireless Hemodynamic Monitoring in Patients with Heart Failure

“…Rathman and colleagues reported that patients relayed improvements in perception of disease control and symptom reduction, while being satisfied with use of the system [53]. A small pilot study in left ventricular assist device (LVAD) patients demonstrated that none of the patients who received a CardioMEMS™ device and associated optimization before LVAD surgery had the occurrence of the primary endpoint of mortality, right-sided HF, or renal replacement therapy [54]. Another population of interest is pulmonary hypertension (PH).…”

Implemented models and elements for heart failure care in the regions of the Russian Federation: prospects for transformation into regional cardiovascular risk management systems

“…Улучшение приверженности и повышение эффективности мониторинга пациента может быть достигнуто при использовании мобильного приложения [11]. При коррекции терапии СН на основе измерения давления в легочной артерии устройством CardioMems удалось снизить количество госпитализаций по поводу СН и смерти, при низкой частоте осложнений и ситуаций неисправности устройства [12]. Тем не менее, высокая стоимость и инвазивность вмешательства существенно ограничивают его использование в широкой практике.…”

Case Report: Ambient Sensor Signals as Digital Biomarkers for Early Signs of Heart Failure Decompensation

“…However, based on available evidence, routine use of external RPM devices is not recommended ( 4 ). Non-hemodynamic monitoring includes interventions ranging from telephone calls only, weight monitoring to complex multi-variable telemonitoring strategies making it difficult to conclude which component drives the effect ( 5 ).…”