Wearable Devices Based on Bioimpedance Test in Heart Failure: Clinical Relevance: Systematic Review.

Area of Science:

• Biomedical Engineering
• Cardiology
• Medical Devices

Background:

• Heart failure (HF) is a leading cause of hospitalizations, often driven by fluid overload.
• Bioimpedance (BI) monitoring of tissue hydration offers potential for managing HF congestion.
• Wearable BI devices are emerging as tools for remote HF patient monitoring.

Purpose of the Study:

• To systematically review the clinical relevance of wearable bioimpedance devices for monitoring fluid status in heart failure patients.
• To assess the diagnostic and prognostic capabilities of these devices.

Main Methods:

• A systematic literature review was conducted across five major databases (PubMed, Scopus, Cochrane, Web of Science, Embase) following PRISMA guidelines.
• Included studies assessed wearable BI devices in HF patients, with risk of bias evaluated using the ROBINS tool.
• Data extraction focused on device efficacy in fluid monitoring, prediction of HF events, and prognostic value.

Main Results:

• Ten articles involving 535 participants were reviewed.
• Significant differences in BI values were observed between HF patients and controls, and between congestive and non-congestive HF patients.
• Devices demonstrated a sensitivity of 70.0% and specificity of 89.1% for predicting HF worsening events.
• Decreased R_80kHz was associated with increased all-cause mortality (HR 5.51) and HF admissions (HR 4.96).

Conclusions:

• Wearable BI devices are effective in detecting fluid overload and show potential for HF management.
• Further technological advancements and clinical studies are necessary to establish their routine use and optimize prognostic impact compared to standard care.