Key result
Multisensor CIED remote monitoring cuts HF hospitalizations and unplanned outpatient visits ~41% vs standard care.
Why the study?
The impact of newer multisensor CIED-based algorithms on clinical outcomes remains uncertain, leading to limited recommendations in current heart failure guidelines.
Does multisensor CIED-based HF home monitoring reduce mortality, HF hospitalizations, and unplanned outpatient HF visits in heart failure patients with CIEDs?
Systematic Review
Does multisensor CIED-based HF home monitoring reduce mortality, HF hospitalizations, and unplanned outpatient HF visits in heart failure patients with CIEDs?
Effect estimate: IRR 0.59 (95% CI 0.39-0.88)
Multisensor CIED-based algorithms significantly reduce HF hospitalizations, but prospective validation in RCTs is still lacking for commercially available algorithms.
Supports multisensor CIED monitoring to reduce HF hospitalizations; leaves open prospective RCT confirmation before practice change.
PURPOSE OF REVIEW: Cardiac Implantable Electronic Device (CIED)-based remote monitoring has been proposed to improve heart failure (HF) management by enabling early detection of decompensation. This systematic review evaluates the effectiveness of multisensor CIED-based monitoring in reducing mortality, HF hospitalizations, and unplanned HF outpatient visits. RECENT FINDINGS: Earlier CIED-based remote monitoring strategies were mainly based on single-sensor impedance-based algorithms, and showed limited clinical benefits. Newer multisensor CIED-based algorithms have shown promise in initial studies. However, their impact on clinical outcomes remains uncertain, and therefore current HF guidelines provide limited recommendations. Multisensor CIED-based algorithms reliably identify high-risk HF patients and their use leads to reductions in HF hospitalizations and unplanned outpatient HF visits, although prospective validation in RCTs is lacking for any of the algorithms. Standardized response strategies are needed to enhance clinical integration and generalizability. If validated, multisensor monitoring could become a key tool in HF management.
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Zwaenepoel et al. (2025) conducted a systematic review in Heart failure. Multisensor CIED-based remote monitoring vs. Standard care was evaluated on Heart failure hospitalizations (IRR 0.59, 95% CI 0.39-0.88). Multisensor CIED-based remote monitoring significantly reduced heart failure hospitalizations (IRR 0.59) and unplanned outpatient visits (IRR 0.59) compared to standard care, though it did not significantly reduce mortality.
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