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Review
. 2024 Nov 14;14(22):2554.
doi: 10.3390/diagnostics14222554.

Remote Management of Heart Failure in Patients with Implantable Devices

Luca Santini  1 , Francesco Adamo  1 , Karim Mahfouz  1 , Carlo Colaiaco  1 , Ilaria Finamora  1 , Carmine De Lucia  1 , Nicola Danisi  1 , Stefania Gentile  1 , Claudia Sorrentino  1 , Maria Grazia Romano  1 , Luca Sangiovanni  1 , Alessio Nardini  2 , Fabrizio Ammirati  1
Affiliations
Review

Remote Management of Heart Failure in Patients with Implantable Devices

Luca Santini et al. Diagnostics (Basel). .

Abstract

Background: Heart failure (HF) is a chronic disease with a steadily increasing prevalence, high mortality, and social and economic costs. Furthermore, every hospitalization for acute HF is associated with worsening prognosis and reduced life expectancy. In order to prevent hospitalizations, it would be useful to have instruments that can predict them well in advance. Methods: We performed a review on remote monitoring of heart failure through implantable devices. Results: Precise multi-parameter algorithms, available for ICD and CRT-D patients, have been created, which also use artificial intelligence and are able to predict a new heart failure event more than 30 days in advance. There are also implantable pulmonary artery devices that can predict hospitalizations and reduce the impact of heart failure. The proper organization of transmission and alert management is crucial for clinical success in using these tools. Conclusions: The full implementation of remote monitoring of implantable devices, and in particular, the use of new algorithms for the prediction of acute heart failure episodes, represents a huge challenge but also a huge opportunity.

Keywords: CIEDs; CardioMEMS; HeartInsight; HeartLogic; Triage-HF; digital medicine; heart failure; remote monitoring; telemedicine.

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Conflict of interest statement

Santini has been a consultant for Boston Scientific, Abbott, and Medtronic and has received speaker fees from Zoll. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

Figure 1
Figure 1
Progression of worsening heart failure [1].
Figure 2
Figure 2
From device monitoring to remote patient management.
Figure 3
Figure 3
Pathophysiological course of an episode of acute heart failure in the month preceding the symptoms, resulting in changes in heart tones, heart rate, heart rate variability, intrathoracic impedance, respiratory parameters, and physical activity. These changes can be detected by new algorithms that can predict an episode of acute heart failure well in advance. S1, first heart sound; S3, third heart sound; HR, heart rate; HRV, heart rate variability [4].
Figure 4
Figure 4
Average sensor value changes in patients with a heart failure event (matched paired analysis) from the Multisense study.
Figure 5
Figure 5
The CardioMEMS pulmonary artery pressure sensor and patient electronics unit. Figures used with permission from Abbott.
See this image and copyright information in PMC

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