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September 14, 2026European Heart Journal - Quality of Care and Clinical OutcomesOpen Access

Economic Evaluations of Invasive Devices for Remote Cardiac Monitoring in Chronic Heart Failure: A Scoping Review

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Why the study?

Are invasive cardiac monitoring and CIED remote monitoring cost-effective compared to in-office follow-up in adult heart failure patients?

Population

19 studies across 11 countries evaluating adult heart failure patients

Comparison

Invasive cardiac monitoring or cardiac… vs In-office follow-up

Design

Systematic_review

Key result

Invasive cardiac monitoring and CIED remote monitoring were cost-effective or cost-saving compared with in-office follow-up across 19 economic evaluation studies.

Authors

ACAngelo CapodiciFNFrancesca NociMCMichele Coceani

Discussion

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Overview

Both strategies show cost-effectiveness in HF management; reinforces recent guidance and extends evidence across systems.

Key Points

  • To evaluate the cost-effectiveness and economic value of invasive hemodynamic monitoring devices and cardiac implantable electronic device remote monitoring across diverse healthcare systems in chronic heart failure.
  • Conducted a scoping review searching PubMed and Scopus through March 2026 for peer-reviewed economic evaluations (including cost-effectiveness and cost-utility analyses) in adults with heart failure.
  • Identified and synthesized data from 19 published studies across 11 countries, categorizing interventions into standalone invasive sensors and cardiac implantable electronic device remote monitoring.
  • Standalone invasive sensors (primarily CardioMEMS, 10 studies) were cost-effective in high-income settings, including the United States, United Kingdom, and continental Europe, but exceeded willingness-to-pay thresholds in Argentina due to high device acquisition costs.
  • Remote monitoring for cardiac implantable electronic devices (9 studies) consistently demonstrated cost-neutral or cost-saving outcomes compared with standard in-office visits, generating the largest cost savings among recipients of cardiac resynchronization therapy defibrillators.
  • Advanced predictive alert algorithms exhibited highly favorable economic profiles, although identified evaluations lacked comparative trials against identical device platforms with algorithms turned off.

Structured PICO

Are invasive cardiac monitoring and CIED remote monitoring cost-effective compared to in-office follow-up in adult heart failure patients?

P
Population
19 economic evaluation studies across 11 countries assessing invasive cardiac monitoring or cardiac implantable electronic device remote monitoring in adult heart failure patients.
I
Intervention
Invasive cardiac monitoring (standalone invasive sensors, predominantly CardioMEMS) or cardiac implantable electronic device (CIED) remote monitoring (standard platforms and advanced alerts like HeartLogic, TriageHF Plus)
C
Comparator
In-office follow-up
O
Outcome
Cost-effectiveness or cost-utility

Invasive hemodynamic and device-based remote monitoring are economically advantageous for heart failure management across multiple healthcare systems, particularly in high-income settings.

Limitations

  • Lacked ideal comparators testing identical device platforms with the algorithm deactivated
  • Lack of dedicated evaluations in low- and middle-income countries

Cite This Study

Capodici et al. (2026) conducted a review in chronic heart failure (n=19). Invasive cardiac monitoring and cardiac implantable electronic device remote monitoring vs. In-office follow-up was evaluated on Cost-effectiveness. Invasive cardiac monitoring and CIED remote monitoring were cost-effective or cost-saving compared with in-office follow-up across 19 economic evaluation studies.

synapsesocial.com/papers/6aa7afef79e9260bc85aacf5https://doi.org/10.1093/ehjqcco/qcag138
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