Feasibility of Self-measurement Telemonitoring Using a Handheld Heart Sound Recorder in Patients with Heart Failure – SELPH multicenter pilot study

Abstract Introduction: Multi-parametric assessment, including heart sounds in addition to conventional parameters, may enhance the efficacy of noninvasive telemonitoring for heart failure (HF). We sought to assess the feasibility of self-telemonitoring with multiple devices including a handheld heart sound recorder and its association with clinical events in patients with HF. Methods Ambulatory HF patients recorded their own heart sounds, mono-lead electrocardiograms, oxygen saturation, body weight, and vital signs using multiple devices every morning for six months. Results In the 77 patients enrolled (63 ± 13 years old, 84% male), daily measurements were feasible with a self-measurement rate of > 70% of days in 75% of patients. Younger age and higher Minnesota Living with Heart Failure Questionnaire scores were independently associated with lower adherence (P = 0.001 and 0.017, respectively). A usability questionnaire showed that 87% of patients felt self-telemonitoring was helpful, and 96% could use the devices without routine cohabitant support. Six patients experienced 10 HF events of re-hospitalization and/or unplanned hospital visits due to HF. In patients who experienced HF events, a significant increase in heart rate and diastolic blood pressure and a decrease in the time interval from Q wave onset to the second heart sound were observed 7 days before the events compared with those without HF events. Conclusions Self-telemonitoring with multiple devices including a handheld heart sound recorder was feasible even in elderly patients with HF. This intervention may confer a sense of relief to patients and enable monitoring of physiological parameters that could be valuable in detecting the deterioration of HF.