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Review
. 2025 Jul 1;22(1):21.
doi: 10.1007/s11897-025-00707-y.

Impact of Multisensor CIED-based Heart Failure Monitoring on Mortality, Heart Failure Hospitalizations and Outpatient Visits: A Systematic Review

Bert A C Zwaenepoel #  1   2 , Annefleur Kluft #  3 , Michelle Feijen #  3 , Jan W Schoones  4 , Ward A Heggermont  5 , Anastasia D Egorova #  3 , Saskia L M A Beeres #  3
Affiliations
Review

Impact of Multisensor CIED-based Heart Failure Monitoring on Mortality, Heart Failure Hospitalizations and Outpatient Visits: A Systematic Review

Bert A C Zwaenepoel et al. Curr Heart Fail Rep. .

Abstract

Purpose of review: Cardiac Implantable Electronic Device (CIED)-based remote monitoring has been proposed to improve heart failure (HF) management by enabling early detection of decompensation. This systematic review evaluates the effectiveness of multisensor CIED-based monitoring in reducing mortality, HF hospitalizations, and unplanned HF outpatient visits.

Recent findings: Earlier CIED-based remote monitoring strategies were mainly based on single-sensor impedance-based algorithms, and showed limited clinical benefits. Newer multisensor CIED-based algorithms have shown promise in initial studies. However, their impact on clinical outcomes remains uncertain, and therefore current HF guidelines provide limited recommendations. Multisensor CIED-based algorithms reliably identify high-risk HF patients and their use leads to reductions in HF hospitalizations and unplanned outpatient HF visits, although prospective validation in RCTs is lacking for any of the algorithms. Standardized response strategies are needed to enhance clinical integration and generalizability. If validated, multisensor monitoring could become a key tool in HF management.

Keywords: Cardiac Implantable Electronic Devices (CIEDs); Heart Failure; HeartInsight; HeartLogic; Remote Monitoring; TriageHF.

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Conflict of interest statement

Declarations. Competing Interests: The authors declare no competing interests. Conflict of interest: Bert Zwaenepoel, Annefleur Kluft, Michelle Feijen, Jan Schoones declare that they have no conflicts of interest. Ward Heggermont reports personal fees from Boston Scientific, outside the submitted work. Anastasia Egorova reports personal fees from Medtronic Trading, personal fees from Boston Scientific, personal fees from Abbott, during the conduct of the study. Saskia Beeres reports personal fees from Boston Scientific, personal fees from Medtronic Trading, during the conduct of the study; personal fees from Boehringer Ingelheim, outside the submitted work. Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Fig. 1
Fig. 1
The chronic heart failure path and its physiological changes detectable by CIEDs Panel A: Traditional perspective on the progression of chronic heart failure and the early physiological changes detectable by contemporary cardiac implantable electronic device (CIED) algorithms prior to the onset of decompensation related symptoms. Panel B: schematic representation of the specific parameters integrated into the commercially available algorithms HeartInsight, HeartLogic, and TriageHF.
Fig. 2
Fig. 2
PRISMA flow diagram PRISMA flow diagram illustrating the selection process for studies included in the systematic review. The diagram details the number of records identified, screened, assessed for eligibility, and included, along with reasons for exclusion at each stage
Fig. 3
Fig. 3
Comparison of clinical outcomes in multisensor CIED-based HF monitoring: all-cause or cardiovascular mortality, heart failure hospitalization, and urgent outpatient heart failure visits Panel A: studies reporting all-cause and/or cardiovascular mortality as primary outcomes.  Panel B: studies focusing on heart failure hospitalization as an outcome. Panel C: studies evaluating unplanned outpatient heart failure visits as an outcome
See this image and copyright information in PMC

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