Don’t Put Too Much Weight on Weight Telemonitoring in High-Risk Heart Failure Patients!

This article refers to ‘Weight telemonitoring of heart failure versus standard of care in a real-world setting: Results on mortality and hospitalizations in a 6-month nationwide matched cohort study’ by F. Roubille et al. , published in Eur J Heart Fail 2024;26: 1 20 1 – 1 2 1 4. In patients with heart failure (HF), worsening signs and symptoms are the main reason for hospitalization. Repeat worsening episodes along the natural HF trajectory are closely associated with disease progression and mortality risk. Despite major therapeutic advances, HF-related mortality and morbidity remain high, and the personal, societal and economic burden of recurrent HF hospitalization (HFH) continues to grow. Therefore, policy makers, health-care providers and payers see preventive strategies to reduce HFH by improving ambulatory HF care as increasingly important. Social distancing requirements during the COVID-1 9 pandemic further accelerated the transition from clinic-based to remote patient management (RPM), and current European Society of Cardiology (ESC) guidelines strongly recommend delivery of healthcare at home. 1 Telemonitoring was introduced to improve recognition of imminent worsening HF (WHF) in the outpatient setting. Although promising in small early studies, larger randomized controlled trials (RCTs) had conflicting results, with no convincing evidence that monitoring for changes in weight, symptoms and vital parameters could reduce clinical outcome events. Since then, various non-invasive (clinical) and invasive (haemodynamic) surveillance strategies were examined, and aggregated data indicate significantly lower numbers of HFH in individuals undergoing telemonitoring (reviewed by Stevenson et al. 2 )