Remote heart failure monitoring

Heart failure is associated with a very high rate of hospitalization, which has become a major target for quality improvement. A key strategy for reducing hospitalizations is remote heart failure monitoring. Remote monitoring systems that rely on assessment of symptoms, vital signs, and daily weight change have not consistently lowered the rate of heart failure hospitalization. Device-based measurement of physiological parameters, such as heart rate variability and intrathoracic impedance, provide a means to assess the risk of worsening heart failure and the possibility of future hospitalization, but have not yet been shown to reduce the rate of heart failure hospitalization. Investigational implantable hemodynamic monitors have the potential to direct day-to-day management of heart failure patients to significantly reduce hospitalization rates, and their use is supported by recent studies. Finally, newer noninvasive technologies also appear promising.