Remote monitoring via implanted devices in heart failure: rising star or lame duck?

摘要

Implantable cardioverter-defibrillators (ICDs) have become standard therapy for patients with poor systolic function and low left ventricular ejection fraction, most often due to ischaemic heart disease, and also non-ischaemic cardiomyopathy. These patients are thus protected from life-threatening arrhythmias but remain at risk of deterioration of cardiac function leading to decompensation. Cardiac resynchronization therapy can improve symptoms of heart failure and mortality in advanced heart failure but has more recently been shown to also reduce mortality in milder heart failure patients with broad QRS complexes. Implantation rates have been shown to be increasing steadily in Europe and it is expected that they will increase further after the recent updated guidelines on device therapy in heart failure. These devices can increasingly be connected to remote monitoring to assess device function but also heart failure-related parameters. Prospective data on the use of remote monitoring is scarce but is being increasingly used also in the light of recent device-related malfunctions. The use of parameters that can predict heart failure-related complications can be an important add-on to these remote technical device check-ups.