Integrating remote CIED monitoring into heart failure care: evidence, challenges, and opportunities

Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) has evolved from simple device integrity checks to a cornerstone of personalized heart failure (HF) management. By enabling early detection of subclinical deterioration, CIED-based RM supports proactive clinical interventions, potentially reducing hospitalizations and improving outcomes. Multiparametric algorithms such as HeartLogic, TriageHF, and HeartInsight integrate hemodynamic and arrhythmic parameters to predict HF events with good sensitivity. However, despite increasing evidence of clinical and economic benefits, RM implementation remains inconsistent due to heterogeneous protocols, data latency, and inadequate reimbursement structures. This review summarizes current evidence, operational challenges, and future opportunities for integrating remote CIED monitoring into comprehensive HF care pathways, highlighting the role of artificial intelligence and the need for standardized workflows and reimbursement models.