Proactive monitoring: implications of implantable devices for future heart failure management

Heart failure (HF) decompensation continues to account for approximately 1 million hospitalizations per year in the United States. Pulmonary congestion is the hallmark sign of worsening HF. Better strategies aimed at identifying subclinical congestion would be of great value in the management of HF. Implantable hemodynamic and/or thoracic impedance monitoring systems, both currently available and under investigation, can detect pulmonary congestion before traditional signs and symptoms occur. These implantable monitors can provide valuable information of ongoing fluid status. Data retrieval can be useful for monitoring effectiveness of treatment and patient teaching, thereby resulting in an individualized treatment regimen based on real-time data. Proactive monitoring of HF patients may prevent future HF decompensation.