Zwaenepoel Bert A C, Kluft Annefleur, Feijen Michelle, Schoones Jan W, Heggermont Ward A, Egorova Anastasia D, Beeres Saskia L M A
Department of Cardiology, AZ Delta, Roeselare, Belgium.
Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.
Curr Heart Fail Rep. 2025 Jul 1;22(1):21. doi: 10.1007/s11897-025-00707-y.
Cardiac Implantable Electronic Device (CIED)-based remote monitoring has been proposed to improve heart failure (HF) management by enabling early detection of decompensation. This systematic review evaluates the effectiveness of multisensor CIED-based monitoring in reducing mortality, HF hospitalizations, and unplanned HF outpatient visits.
Earlier CIED-based remote monitoring strategies were mainly based on single-sensor impedance-based algorithms, and showed limited clinical benefits. Newer multisensor CIED-based algorithms have shown promise in initial studies. However, their impact on clinical outcomes remains uncertain, and therefore current HF guidelines provide limited recommendations. Multisensor CIED-based algorithms reliably identify high-risk HF patients and their use leads to reductions in HF hospitalizations and unplanned outpatient HF visits, although prospective validation in RCTs is lacking for any of the algorithms. Standardized response strategies are needed to enhance clinical integration and generalizability. If validated, multisensor monitoring could become a key tool in HF management.
基于心脏植入式电子设备（CIED）的远程监测已被提议通过早期发现失代偿来改善心力衰竭（HF）管理。本系统综述评估了基于多传感器CIED监测在降低死亡率、HF住院率和非计划HF门诊就诊方面的有效性。
早期基于CIED的远程监测策略主要基于单传感器阻抗算法，临床益处有限。更新的基于多传感器CIED的算法在初步研究中显示出前景。然而，它们对临床结局的影响仍不确定，因此当前HF指南提供的建议有限。基于多传感器CIED的算法能够可靠地识别高危HF患者，其使用可减少HF住院率和非计划门诊HF就诊，尽管尚无任何算法在随机对照试验（RCT）中得到前瞻性验证。需要标准化的应对策略来加强临床整合和推广。如果得到验证，多传感器监测可能成为HF管理的关键工具。
