Current Heart Failure Reports

, Volume 12, Issue 4, pp 269–275 | Cite as

Role of Monitoring Devices in Preventing Heart Failure Admissions

  • Kenneth McDonald
  • Mark WilkinsonEmail author
  • Mark Ledwidge
Pathophysiology of Myocardial Failure (I Anand and M Patarroyo-Aponte, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Pathophysiology of Myocardial Failure


This review aims to discuss and summarize the evidence base for devices that have a role in monitoring patients with heart failure for the purpose of attempting to prevent heart failure-related admissions. Despite contemporary heart failure service provision, many patients continue to need acute admission for decompensation. There is a clinical need for a better strategy for predicting decompensation earlier so that appropriate therapeutic interventions can be commenced sooner in order to prevent the need for acute hospital admission. Between clinical assessment visits, the contemporary approach to management is based primarily on daily home monitoring of weight by patients; while this has proved useful, it falls short. For example, substantial weight gain was seen in only 20 % of ADHF admission patients according to data collected in the TEN-HMS home telemonitoring study. Monitoring devices offer the possibility of tracking additional physiological or haemodynamic parameters that may allow for earlier detection and more accurate identification of patients at risk of acute decompensation.


Telemedicine Health technology Personalized care Early detection Risk score Haemodynamics 


Compliance with Ethics Guidelines

Conflict of Interest

Kenneth McDonald has received grants from the Heartbeat Trust Limited, European Commission Framework Programme 7 and Department of Health and Health Services Executive of the Irish Government.

Mark Wilkinson has received grants from the Heartbeat Trust Limited, European Commission Framework Programme 7 and Department of Health and Health Services Executive of the Irish Government during the conduct of the study and personal fees from Solvotrin Therapeutics outside the submitted work.

Mark Ledwidge has received grants from the Heartbeat Trust Limited, European Commission Framework Programme 7 and Department of Health and Health Services Executive of the Irish Government.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


  1. 1.
    Lewin J, Ledwidge M, O’Loughlin C, McNally C, McDonald K. Clinical deterioration in established heart failure: what is the value of BNP and weight gain in aiding diagnosis? Eur J Heart Fail. 2005;7(6):953–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Klersy C et al. A meta-analysis of remote monitoring of heart failure patients. J Am Coll Cardiol. 2009;54(18):1683–94.PubMedCrossRefGoogle Scholar
  3. 3.
    Inglis SC et al. Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Cochrane Database Syst Rev. 2010;4(8):CD007228. doi: 10.1002/14651858.CD007228.pub2.Google Scholar
  4. 4.
    Koehler F et al. Telemedical Interventional Monitoring in Heart Failure (TIM-HF), a randomized, controlled intervention trial investigating the impact of telemedicine on mortality in ambulatory patients with heart failure: study design. Eur J Heart Fail. 2010;12(12):1354–62.PubMedCrossRefGoogle Scholar
  5. 5.
    Chaudhry SI et al. Telemonitoring in patients with heart failure. N Engl J Med. 2010;363:2301–9.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Anand IS et al. Design of the multi-sensor monitoring in congestive heart failure (MUSIC) study: prospective trial to assess the utility of continuous wireless physiologic monitoring in heart failure. J Card Fail. 2011;17(1):11–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Kotb A et al. Comparative effectiveness of different forms of telemedicine for individuals with heart failure (HF): a systematic review and network meta-analysis. PLoS One. 2015;10(2):e0118681. doi: 10.1371/journal.pone.0118681.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Aronson D et al. Measures of heart period variability as predictors of mortality in hospitalized patients with decompensated congestive heart failure. Am J Cardiol. 2004;93(1):59–63.PubMedCrossRefGoogle Scholar
  9. 9.
    Hindricks et al. Implant-based multiparameter telemonitoring of patients with heart failure (IN-TIME): a randomised controlled trial. Lancet. 2014;384(9943):583–90.PubMedCrossRefGoogle Scholar
  10. 10.
    Ewald G et al. Automated HF decompensation detection: results from the decompensation detection study (decode). J Card Fail. 2009;15(6):S122. doi: 10.1016/j.cardfail.2009.06.065.CrossRefGoogle Scholar
  11. 11.
    Wang L et al. Feasibility of using an implantable system to measure thoracic congestion in an ambulatory chronic heart failure canine model. Pacing Clin Electrophysiol. 2005;28(5):404–11.PubMedCrossRefGoogle Scholar
  12. 12.
    Van Veldhuisen D. Diagnostic Outcome Trial in Heart Failure (DOT-HF Trial). Circulation. 2011.Google Scholar
  13. 13.
    Yu CM et al. Intrathoracic impedance monitoring in patients with heart failure: correlation with fluid status and feasibility of early warning preceding hospitalization. Circulation. 2005;112(6):841–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Whellan, et al. Program to Access and Review Trending Information and Evaluate Correlation to Symptoms in Patients With Hear Failure, (PARTNERS-HF). JACC. 2010.Google Scholar
  15. 15.
    Conraads V et al. Sensitivity and positive predictive value of implantable intrathoracic impedance monitoring as a predictor of heart failure hospitalizations: the SENSE-HF trial. Eur Heart J. 2011;32(18):2266–73.PubMedCrossRefGoogle Scholar
  16. 16.
    Cowie M et al. Development and validation of an integrated diagnostic algorithm derived from parameters monitored in implantable devices for identifying patients at risk for heart failure hospitalization in an ambulatory setting. Eur Heart J. 2013;34(31):2472–80.PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Bourge R et al. Randomized controlled trial of an implantable continuous hemodynamic monitor in patients with advanced heart failure: the COMPASS-HF study. J Am Coll Cardiol. 2008;51(11):1073–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Abraham W. CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients, (CHAMPION). Lancet. 2011.Google Scholar
  19. 19.
    Krahnke JS et al. Heart failure and respiratory hospitalizations are reduced in patients with heart failure and chronic obstructive pulmonary disease with the use of an implantable pulmonary artery pressure monitoring device. J Card Fail. 2015;21(3):240–9.PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Ritzema J et al. Direct left atrial pressure monitoring in ambulatory heart failure patients. Circulation. 2007;116:2952–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Ritzema J et al. Physician-directed patient self-management of left atrial pressure in advanced chronic heart failure. Circulation. 2010;121(9):1086–95.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Kenneth McDonald
    • 1
    • 2
    • 3
  • Mark Wilkinson
    • 1
    • 2
    Email author
  • Mark Ledwidge
    • 3
  1. 1.St Vincent’s University HospitalDublinIreland
  2. 2.University College DublinDublinIreland
  3. 3.HeartBeat TrustDublinIreland

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