Efficacy of wearable devices detecting pulmonary congestion in heart failure: a systematic review and meta-analysis

Heart failure (HF) hospitalizations are prognostically significant. Implantable hemodynamic monitors detect early congestion but are invasive and costly, with no clear mortality benefit. Wearable devices offer a non-invasive alternative for monitoring congestion. This meta-analysis examines the efficacy of wearable devices in reducing HF hospitalizations and mortality compared to standard care.

A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed, EMBASE, MEDLINE, and Cochrane databases were searched for trials comparing wearable device-guided care with standard HF treatment. Outcomes included hospitalisation for HF, worsening HF events (hospitalisation or emergency department visit for HF) and all-cause mortality. Total (first and recurrent) event meta-analyses were performed using random effect models.

Four studies met inclusion criteria, including 958 patients who were enrolled either at the time of or within 10 days of discharge from a hospitalization for HF. Wearable device-guided care resulted in a 41% reduction in hospitalisations for HF (RR: 0.59, 95% CI: 0.41-0.87, p = 0.007) and a 40% reduction in HF events (RR: 0.60, 95% CI: 0.42-0.86, p = 0.005) compared to standard care. All-cause mortality was reduced by 26% in the wearable monitoring arm (RR: 0.74, 95% CI: 0.55-0.99, p = 0.04). The composite outcome of HF hospitalization and mortality was 37% lower with wearable monitoring (RR: 0.63, 95% CI: 0.44-0.91, p = 0.04). Treatment for HF, guided by wearable devices that measure pulmonary congestion, reduced hospitalisations for HF and all-cause mortality in recently hospitalised patients.

Wearable devices are a promising non-invasive strategy for managing high-risk patients, particularly when transitioning care from acute to community settings..

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024607770, identifier PROSPERO CRD42024607770.