Advocate Heart Institute, Advocate Christ Medical Center, Oak Lawn, Illinois.
Second Department of Internal Medicine, University of Toyama, Toyama, Japan.
Curr Opin Cardiol. 2024 May 1;39(3):210-217. doi: 10.1097/HCO.0000000000001119. Epub 2024 Mar 11.
The goal of this review is to describe the current evidence available for remote monitoring devices available for patients with chronic heart failure, and also detail practical clinical recommendations for implementing these tools in daily clinical practice.
Several devices ranging from sophisticated multiparametric algorithms in defibrillators, implantable pulmonary artery pressure sensors, and wearable devices to measure thoracic impedance can be utilized as important adjunctive tools to reduce the risk of heart failure hospitalization in patients with chronic heart failure. Pulmonary artery pressure sensors provide the most granular data regarding hemodynamic status, while alerts from wearable devices for thoracic impedance and defibrillator-based algorithms increase the likelihood of worsening clinical status while also having high negative predictive value when values are within normal range.
Multiple device-based monitoring strategies are available to reduce longitudinal risk in patients with chronic heart failure. Further studies are needed to best understand a practical pathway to integrate multiple signals of data for early clinical decompensation risk predictionVideo abstract: http://links.lww.com/HCO/A95.
本综述旨在描述目前可用于慢性心力衰竭患者的远程监测设备的现有证据，并详细介绍在日常临床实践中实施这些工具的实用临床建议。
可使用多种设备，包括除颤器中的复杂多参数算法、植入式肺动脉压传感器和可测量胸腔阻抗的可穿戴设备，作为重要的辅助工具，以降低慢性心力衰竭患者心力衰竭住院的风险。肺动脉压传感器可提供有关血流动力学状态的最详细数据，而可穿戴设备的胸腔阻抗警报和基于除颤器的算法可增加临床状况恶化的可能性，并且当值处于正常范围时具有较高的阴性预测值。
有多种基于设备的监测策略可用于降低慢性心力衰竭患者的纵向风险。需要进一步的研究来更好地了解整合多种数据信号以预测早期临床失代偿风险的实用途径。视频摘要：http://links.lww.com/HCO/A95.
