Telemonitoring in heart failure: Big Brother watching over you

Abstract Heart failure (HF) is a leading cause of hospitalisations in older people. Several strategies, supported by novel technologies, are now available to monitor patients’ health from a distance. Although studies have suggested that remote monitoring may reduce HF hospitalisations and mortality, the study of different patient populations, the use of different monitoring technologies and the use of different endpoints limit the generalisability of the results of the clinical trials reported, so far. In this review, we discuss the existing home monitoring modalities, relevant trials and focus on future directions for telemonitoring.

[1]  W. Abraham,et al.  Continuous Autonomic Assessment in Patients With Symptomatic Heart Failure: Prognostic Value of Heart Rate Variability Measured by an Implanted Cardiac Resynchronization Device , 2004, Circulation.

[2]  J. Cleland,et al.  It makes SENSE to take a safer road. , 2011, European heart journal.

[3]  A. Rigby,et al.  Noninvasive home telemonitoring for patients with heart failure at high risk of recurrent admission and death: the Trans-European Network-Home-Care Management System (TEN-HMS) study. , 2005, Journal of the American College of Cardiology.

[4]  Helmut Baumgartner,et al.  ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012 , 2012, European journal of heart failure.

[5]  Ron Waksman,et al.  Overview of the 2011 Food and Drug Administration Circulatory System Devices Panel of the Medical Devices Advisory Committee Meeting on the CardioMEMS Champion Heart Failure Monitoring System. , 2013, Journal of the American College of Cardiology.

[6]  Hassan Mansour,et al.  Monitoring of physical activity and heart rate variability in patients with chronic heart failure using cardiac resynchronization devices. , 2005, The American journal of cardiology.

[7]  M. Domingo,et al.  Telemonitorización no invasiva en pacientes ambulatorios con insuficiencia cardiaca: efecto en el número de hospitalizaciones, días de ingreso y calidad de vida. Estudio CARME (CAtalan Remote Management Evaluation) , 2011 .

[8]  Nancy M Albert,et al.  HFSA 2010 Comprehensive Heart Failure Practice Guideline. , 2010, Journal of cardiac failure.

[9]  E. Warman,et al.  Burden of atrial fibrillation and poor rate control detected by continuous monitoring and the risk for heart failure hospitalization. , 2012, American heart journal.

[10]  K. Adams,et al.  Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). , 2005, American heart journal.

[11]  L. Tavazzi,et al.  Sensitivity and positive predictive value of implantable intrathoracic impedance monitoring as a predictor of heart failure hospitalizations: the SENSE-HF trial. , 2011, European heart journal.

[12]  N. Freemantle,et al.  The EuroHeart Failure Survey programme - a survey on the quality of care among patients with heart failure in Europe. Part 2: treatment , 2003 .

[13]  R. Canby,et al.  Intrathoracic impedance vs daily weight monitoring for predicting worsening heart failure events: results of the Fluid Accumulation Status Trial (FAST). , 2011, Congestive heart failure.

[14]  M. Zile,et al.  Application of implantable hemodynamic monitoring in the management of patients with diastolic heart failure: a subgroup analysis of the COMPASS-HF trial. , 2008, Journal of cardiac failure.

[15]  H. Krumholz,et al.  Telemonitoring in patients with heart failure. , 2010, The New England journal of medicine.

[16]  M. Walsh,et al.  Randomized trial of a daily electronic home monitoring system in patients with advanced heart failure: the Weight Monitoring in Heart Failure (WHARF) trial. , 2003, American heart journal.

[17]  Prakash Deedwania,et al.  HFSA 2006 comprehensive heart failure practice guideline , 2006 .

[18]  Deborah Cohen,et al.  Europeans are left to their own devices , 2011, BMJ : British Medical Journal.

[19]  D. Scherr,et al.  Effect of Home-Based Telemonitoring Using Mobile Phone Technology on the Outcome of Heart Failure Patients After an Episode of Acute Decompensation: Randomized Controlled Trial , 2009, Journal of medical Internet research.

[20]  C. Lau,et al.  Intrathoracic Impedance Monitoring in Patients With Heart Failure: Correlation With Fluid Status and Feasibility of Early Warning Preceding Hospitalization , 2005, Circulation.

[21]  Gesica Investigators Randomised trial of telephone intervention in chronic heart failure: DIAL trial , 2005, BMJ : British Medical Journal.

[22]  Sana M. Al-Khatib,et al.  Combined heart failure device diagnostics identify patients at higher risk of subsequent heart failure hospitalizations: results from PARTNERS HF (Program to Access and Review Trending Information and Evaluate Correlation to Symptoms in Patients With Heart Failure) study. , 2010, Journal of the American College of Cardiology.

[23]  L. Stevenson Hemodynamic Goals Are Relevant , 2006 .

[24]  L. Stevenson Are hemodynamic goals viable in tailoring heart failure therapy? Hemodynamic goals are relevant. , 2006, Circulation.

[25]  G. Kay,et al.  Implant Experience with an Implantable Hemodynamic Monitor for the Management of Symptomatic Heart Failure , 2005, Pacing and clinical electrophysiology : PACE.

[26]  Christian Butter,et al.  Clinical utility of intrathoracic impedance monitoring to alert patients with an implanted device of deteriorating chronic heart failure. , 2007, European heart journal.

[27]  C. Israel,et al.  Fluid status monitoring with a wireless network to reduce cardiovascular-related hospitalizations and mortality in heart failure: rationale and design of the OptiLink HF Study (Optimization of Heart Failure Management using OptiVol Fluid Status Monitoring and CareLink) , 2011, European journal of heart failure.

[28]  John G F Cleland,et al.  Predicting hospitalization due to worsening heart failure using daily weight measurement: analysis of the Trans‐European Network‐Home‐Care Management System (TEN‐HMS) study , 2008, European journal of heart failure.

[29]  S Capewell,et al.  More ‘malignant’ than cancer? Five‐year survival following a first admission for heart failure , 2001, European journal of heart failure.

[30]  P. Thokala,et al.  Home telemonitoring or structured telephone support programmes after recent discharge in patients with heart failure: systematic review and economic evaluation. , 2013, Health technology assessment.

[31]  Barry Greenberg,et al.  Primary results of the HABIT Trial (heart failure assessment with BNP in the home). , 2013, Journal of the American College of Cardiology.

[32]  L. Stevenson,et al.  Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial , 2011, The Lancet.

[33]  J. Hendy,et al.  Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial , 2012, BMJ : British Medical Journal.

[34]  M. Domingo,et al.  [Noninvasive remote telemonitoring for ambulatory patients with heart failure: effect on number of hospitalizations, days in hospital, and quality of life. CARME (CAtalan Remote Management Evaluation) study]. , 2011, Revista espanola de cardiologia.

[35]  P. Thokala,et al.  Telemonitoring after discharge from hospital with heart failure: cost-effectiveness modelling of alternative service designs , 2013, BMJ Open.

[36]  J. Cleland,et al.  Enlisting the help of the largest health care workforce--patients. , 2010, JAMA.

[37]  William T. Abraham,et al.  Physician-Directed Patient Self-Management of Left Atrial Pressure in Advanced Chronic Heart Failure , 2010, Circulation.

[38]  L. A. Bonet,et al.  ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012 , 2012, Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir.

[39]  S Capewell,et al.  Heart failure and the aging population: an increasing burden in the 21st century? , 2003, Heart.

[40]  I. Piña,et al.  Forecasting the Impact of Heart Failure in the United States: A Policy Statement From the American Heart Association , 2013, Circulation. Heart failure.

[41]  S. Ebrahim,et al.  Telemonitoring for chronic heart failure: not ready for prime time. , 2010, The Cochrane database of systematic reviews.

[42]  Volkmar Falk,et al.  2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure , 2016, Revista espanola de cardiologia.

[43]  D. Ferrante,et al.  Long-term results after a telephone intervention in chronic heart failure: DIAL (Randomized Trial of Phone Intervention in Chronic Heart Failure) follow-up. , 2010, Journal of the American College of Cardiology.

[44]  M. Zile,et al.  Randomized controlled trial of an implantable continuous hemodynamic monitor in patients with advanced heart failure: the COMPASS-HF study. , 2008, Journal of the American College of Cardiology.

[45]  N Freemantle,et al.  The EuroHeart Failure survey programme-- a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. , 2003, European heart journal.

[46]  J. Cleland,et al.  Remote monitoring after recent hospital discharge in patients with heart failure: a systematic review and network meta-analysis , 2013, Heart.

[47]  Michael Böhm,et al.  Impact of Remote Telemedical Management on Mortality and Hospitalizations in Ambulatory Patients With Chronic Heart Failure: The Telemedical Interventional Monitoring in Heart Failure Study , 2011, Circulation.

[48]  M. Zile,et al.  Transition From Chronic Compensated to Acute Decompensated Heart Failure: Pathophysiological Insights Obtained From Continuous Monitoring of Intracardiac Pressures , 2008, Circulation.

[49]  Simon Capewell,et al.  The current cost of heart failure to the National Health Service in the UK , 2002, European journal of heart failure.

[50]  Dominique Hansen,et al.  Effect of a telemonitoring‐facilitated collaboration between general practitioner and heart failure clinic on mortality and rehospitalization rates in severe heart failure: the TEMA‐HF 1 (TElemonitoring in the MAnagement of Heart Failure) study , 2012, European journal of heart failure.

[51]  Stephen Morris,et al.  A randomized trial of home telemonitoring in a typical elderly heart failure population in North West London: results of the Home‐HF study , 2009, European journal of heart failure.

[52]  M. Borggrefe,et al.  Intrathoracic Impedance Monitoring, Audible Patient Alerts, and Outcome in Patients With Heart Failure , 2011, Circulation.

[53]  M. Konstam,et al.  A multicenter randomized controlled evaluation of automated home monitoring and telephonic disease management in patients recently hospitalized for congestive heart failure: the SPAN-CHF II trial. , 2010, Journal of cardiac failure.

[54]  J. Cleland,et al.  Which components of heart failure programmes are effective? A systematic review and meta‐analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8323 patients: Abridged Cochrane Review , 2011, European journal of heart failure.

[55]  William T. Abraham,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 , 2013, European heart journal.

[56]  M. Bardsley,et al.  Effect of telephone health coaching (Birmingham OwnHealth) on hospital use and associated costs: cohort study with matched controls , 2013, BMJ.

[57]  Martin Knapp,et al.  Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial , 2013, BMJ.

[58]  Maurizio Marzegalli,et al.  Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators: The Evolution of Management Strategies of Heart Failure Patients With Implantable Defibrillators (EVOLVO) Study , 2012, Circulation.