Adherence to European guidelines in heart failure management: insights from the REMOTE-HF study using remote monitoring

Background Heart failure (HF) is a growing global health challenge, particularly in older populations. The European Society of Cardiology (ESC) guidelines emphasize evidence-based management, including pharmacological treatments, device therapies, and lifestyle interventions. The REMOTE-HF study leverages the Satelia Cardio remote monitoring platform to evaluate adherence to ESC guidelines and assess clinical characteristics, prescribed therapies, and the role of remote monitoring in optimizing HF care. Methods The REMOTE-HF study included 20,310 patients enrolled in the Satelia Cardio remote monitoring program, with data extracted on December 15, 2024. Key clinical parameters such as age, gender, NYHA classification, LVEF, and HF etiology were analyzed. Prescribed therapies, including ACEi/ARB/ARNi, beta-blockers, MRAs, and SGLT2 inhibitors, were compared against ESC guideline-directed medical therapy (GDMT). Adherence was evaluated across patient profiles and cardiologist practices (outpatient vs. hospital-based). Results Among the cohort, 63% of patients were classified as NYHA Class II, 30% as Class III, and 3% as Class IV. LVEF distribution included 45% with reduced EF (<40%), 21% with mid-range EF (40–50%), and 34% with preserved EF (≥50%). Ischemic (43%), rhythmic (34%), and valvular (14%) etiologies were most common. Adherence to ESC guidelines was high, particularly for patients with reduced EF, with widespread use of beta-blockers, ACEi/ARNi, MRAs, and increasing utilization of SGLT2 inhibitors. Device therapies (CRT, ICD) were appropriately prescribed in eligible patients with reduced EF and arrhythmic etiologies. Remote monitoring enabled frequent treatment adjustments, improving adherence. However, disparities in HF management outcomes were observed between outpatient and hospital-based cardiologists. Detailed data will be presented at the congress. Conclusion The REMOTE-HF study underscores the value of Satelia Cardio remote monitoring in enhancing adherence to ESC guidelines for HF management. The data shows effective use of pharmacological and device-based therapies in line with current recommendations.