Remote Monitoring of Heart Failure in Patients with Implantable Cardioverter-Defibrillators: Current Status and Future Needs

Figures

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  Figure 1. Overview of remote monitoring systems. Reproduced with permission from Ploux et al. (J Am Coll Cardiol EP, 2018) [5].

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  Figure 2. Trend of the OptiVol 2 fluid index and the daily measured intrathoracic impedance (Ohms). The threshold of the fluid index is at the nominal value of 60 (gray horizontal line).

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  Figure 3. Trend of the CorVueTM congestion monitoring. This example illustrates the potentially misleading information displayed on the device follow-up report. The graphic shows seven episodes of congestion with different days of duration (pre-activation state: checked bars) that generated alarms (post-activation state: oblique lined bars) for four of these episodes without an associated clinical event (false positive). Reproduced with permission from Palfy et al. (Pacing Clin Electrophysiol, 2018) [14].

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  Figure 4. Example of HeartLogicTM. At the red line, the patient discontinued diuretic therapy, resulting in weight gain. Diuretic therapy was then restored (green line). The HeartLogicTM index analysis showed crossing of the alarm threshold value, set at a default value of 16 (blue line), with an early warning 10 days in advance compared with clinical evaluations. After therapy restoration, the HeartLogicTM index normalized. Reproduced and modified with permission from Capucci et al. (ESC Heart Fail, 2019) [20].

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  Figure 5. Pooled relative risk for randomized clinical trials examining the effect of remote monitoring on all-cause mortality among patients with an implantable cardioverter-defibrillator or cardiac resynchronization defibrillator. Abbreviations: 95% CI = 95% confidence intervals; M-H = Mantel–Haenszel test.

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  Figure 6. Pooled relative risk for randomized clinical trials examining the effect of remote monitoring on heart-failure-related hospitalization.