Remote Monitoring to Reduce Heart Failure Readmissions
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Purpose of Review
Rehospitalization for heart failure remains a challenge in the treatment of affected patients. The ability to remotely monitor patients for worsening heart failure may provide an avenue through which therapeutic interventions can be made to prevent a rehospitalization. Available data on remote monitoring to reduce heart failure rehospitalizations are reviewed within.
Strategies to reduce readmissions include clinical telemonitoring, bioimpedance changes, biomarkers, and remote hemodynamic monitoring. Telemonitoring is readily available, but has low sensitivity and adherence. No data exist to demonstrate the efficacy of this strategy in reducing admissions. Bioimpedance offers improved sensitivity compared to telemonitoring, but has not demonstrated an ability to reduce hospitalizations and is currently limited to those patients who have separate indications for an implantable device. Biomarker levels have shown variable results in the ability to reduce hospitalizations and remain without definitive proof supporting their utilization. Remote hemodynamic monitoring has shown the strongest ability to reduce heart failure readmissions and is currently approved for this purpose. However, remote hemodynamic monitoring requires an invasive procedure and may not be cost-effective.
All currently available strategies to reduce hospitalizations with remote monitoring have drawbacks and challenges. Remote hemodynamic monitoring is currently the most efficacious based on data, but is not without its own imperfections.
KeywordsReadmissions Remote monitoring Bioimpedance Biomarkers Hemodynamic monitoring
Compliance with Ethical Standards
Conflict of Interest
Sitaramesh Emani has received grant funding from St. Jude Medical, Inc. as well as travel reimbursement from Boston Scientific. He has also received grant support from Gilead Sciences and is on the advisory board of CareDX outside of the submitted work.
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.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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