Invasive Devices and Sensors for Remote Care of Heart Failure Patients

Sumant P Radhoe,Jasper J Brugts,Jesse F Veenis

doi:10.3390/s21062014

Abstract

The large and growing burden of chronic heart failure (CHF) on healthcare systems and economies is mainly caused by a high hospital admission rate for acute decompensated heart failure (HF). Several remote monitoring techniques have been developed for early detection of worsening disease, potentially limiting the number of hospitalizations. Over the last years, the scope has been shifting towards the relatively novel invasive sensors capable of measuring intracardiac filling pressures, because it is believed that hemodynamic congestion precedes clinical congestion. Monitoring intracardiac pressures may therefore enable clinicians to intervene and avert hospitalizations in a pre-symptomatic phase. Several techniques have been discussed in this review, and thus far, remote monitoring of pulmonary artery pressures (PAP) by the CardioMEMS (CardioMicroelectromechanical system) HF System is the only technique with proven safety as well as efficacy with regard to the prevention of HF-related hospital admissions. Efforts are currently aimed to further develop existing techniques and new sensors capable of measuring left atrial pressures (LAP). With the growing body of evidence and need for remote care, it is expected that remote monitoring by invasive sensors will play a larger role in HF care in the near future.

Highlights

Despite significant advances in chronic heart failure (CHF) care, the burden of CHF on healthcare systems and economies remains large and is expected to grow during the decade [1,2]
The rate of HF-related hospital admissions was compared between the 6-month time-period prior to CardioMEMS implantation and 6 months after implantation, and a risk reduction of 45% (HR 0.55, 95% CI 0.49–0.61) was found
This review provided an overview of all methods and techniques for invasive remote hemodynamic monitoring in patients with chronic heart failure

Summary

Introduction

Despite significant advances in chronic heart failure (CHF) care, the burden of CHF on healthcare systems and economies remains large and is expected to grow during the decade [1,2]. A major factor contributing to this burden is the high hospital admission rate for acute decompensated heart failure. This high-risk patient group requires frequent contacts in the outpatient clinic setting to timely detect deteriorating disease. These repeated heart failure hospitalizations (HFH) exert a high burden on healthcare systems, and impact patient quality of life and have been associated with impaired prognosis and reduced life expectancy (Figures 1 and 2) [3,4,5]. The need for remote monitoring has become clearer during the current COVID-19 pandemic, which required routine care to be scaled down drastically and required physicians to contact patients by video conference or telephone

Methods

Findings

Discussion

Conclusion