Wearable Devices for Monitoring and Management of Heart Failure: Systematic Literature Review (Preprint)

BACKGROUND Wearable devices, incorporating sensors, data processing, and wireless connectivity, present transformative tools for comprehensive heart failure care. These devices facilitate continuous monitoring, enabling early decompensation detection and real-time feedback. With the potential to revolutionize heart failure management, wearables offer a promising avenue for preventing exacerbations and improving patients' overall quality of life OBJECTIVE The objective of this review is to comprehensively analyze recent advancements in wearable technology for heart failure management. It aims to assess the clinical effectiveness, features, and functions of these devices, explore their role in remote monitoring, and discuss challenges and future directions in the field. METHODS A systematic and comprehensive search was performed on English papers that investigated the development, utilization, and impact of wearable devices in the context of heart failure management. The search encompassed a range of electronic databases. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines was used. RESULTS We identified 1304 articles, of which 270 were eligible for full-text screening. A total of 109 full-text articles were included in the review, revealing a multifaceted landscape of monitoring and management in the context of heart failure. Within this comprehensive body of literature, we identified ten distinct monitoring and management domains: cardiovascular parameters, biomarkers, medication adherence, physical activity, early detection and decompensation, telehealth interventions, wearables, and remote monitoring technologies. Notably, there was a clear trend of increasing research activity across these domains, with a particularly pronounced acceleration observed in recent years, notably in the fields of continuous monitoring of vital signs and remote monitoring technologies. CONCLUSIONS This systematic scoping review offers a comprehensive perspective on recent advances in wearable devices for the monitoring and management of heart failure, shedding light on the diverse array of monitoring domains and approaches utilized in research. The findings of this review underscore the considerable potential for the effectiveness of various monitoring domains, with notable strengths observed in medication monitoring, cardiac function assessment, and digital health applications. As we move forward, future investigations should consider adapting relevant hospital-based diagnostic tools for home use, exploring their potential benefits in a home setting. Furthermore, there is a promising avenue for research to integrate multiple home-monitoring domains, thereby facilitating comprehensive multi-parameter decision-making and enabling personalized clinical decision support to enhance the care of heart failure patients.