Key result
Multiparameter CIED monitoring improves HF detection accuracy but yields inconsistent clinical outcome benefits.
Why the study?
Heart failure deterioration often provides too narrow a therapeutic window to prevent hospitalization, and routine implementation of CIED remote monitoring is not yet widely used in daily care.
Does CIED-enabled remote monitoring improve diagnostic accuracy and prevent worsening heart failure events in patients with heart failure compared to standard care?
Does CIED-enabled remote monitoring improve diagnostic accuracy and prevent worsening heart failure events in patients with heart failure compared to standard care?
Answers are grounded in this paper and cite their sources.
While multiparametric CIED remote monitoring algorithms show promise in detecting impending heart failure deterioration, standardized alert-management protocols and artificial intelligence interpretations may be required before routine clinical implementation is justified.
Despite recent developments, heart failure (HF) remains to be a great burden to the individual patient, entailing major morbidity and mortality. Moreover, HF is a great burden to overall healthcare, mainly because of frequent hospitalizations. Timely diagnosis of HF deterioration and implementation of appropriate therapy may prevent hospitalization and eventually improve a patient's prognosis; however, depending on the patient's presentation, the signs and symptoms of HF often offer too little therapeutic window to prevent hospitalizations. Cardiovascular implantable electronic devices (CIEDs) can provide real-time physiologic parameters and remote monitoring of these parameters can potentially help to identify patients at high risk. However, routine implementation of remote monitoring of CIEDs has still not been widely used in daily patient care. This review gives a detailed description of available metrics for remote HF monitoring, the studies that provide evidence of their efficacy, ways to implement them in clinical HF practice, as well as lessons learned on where to go on from where we currently are.
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Assa et al. (2023) conducted a review in Heart failure. CIED-enabled remote monitoring vs. Standard care / Routine clinical follow-up was evaluated. Multiparameter CIED remote monitoring algorithms improve diagnostic accuracy for detecting worsening heart failure compared to single-parameter intrathoracic impedance, but randomized trials show inconsistent impacts on clinical outcomes.
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