Will the new decade bring home remote monitoring of heart failure patients?

摘要

This issue of the Netherlands Heart Journal contains two articles on management of heart failure [1, 2]. The guideline on heart failure treatment suggests that management of heart failure is fairly straightforward: aiming for maximal medical therapy and at certain disease severity device therapy may be added, all of which can be summarised in a single algorithm to fit all patients with reduced ejection fraction [3, 4]. It seems therefore paradoxical that there is a need to monitor heart failure patients almost continuously and adjust therapy according to objective measures. The reason seems to be that heart failure can deteriorate unexpectedly and spiral down towards life-threatening pump failure or, possibly, lethal arrhythmias despite appropriate medication and adherence to the guidelines. As a result, the clinicians who treat and follow these patients search for objective measures that allow them to see these derailments coming and, most importantly, avert them, thereby avoiding the dreaded outcomes of heart failure.