Table 1: Guidelines on Remote Monitoring in Heart Failure.

European Society of Cardiology (2016):[8] “Telemedicine in HF, which is also termed remote patient management, has variable clinical trial results. Several meta-analyses suggest clinical benefits, but numerous prospectively initiated clinical trials including >3700 patients have not confirmed this.” Monitoring of pulmonary artery pressures using a wireless implantable haemodynamic monitoring system (CardioMems) may be considered in symptomatic patients with HF with previous HF hospitalisation in order to reduce the risk of recurrent HF hospitalisation. (Class IIb, level B.) Multiparameter monitoring based on ICD (IN-TIME approach) may be considered in symptomatic patients with HFrEF (LVEF≤35%) in order to improve clinical outcomes. (Class IIb, level B.)

American College of Cardiology Foundation/American Heart Association Guideline (2013):[9] Systems of Care to Promote Care Coordination for Patients With Chronic HF “The quality of evidence is mixed for specific components of HF clinical management interventions, such as home-based care, disease management, and remote telemonitoring programs… Overall, very few specific interventions have been consistently identified and successfully applied in clinical practice.” Evidence Gaps and Future Research Directions “What is critically needed is an evidence base that clearly identifies best processes of care, especially in the transition from hospital to home.”

Heart Failure Society of America White Paper (2018):[10] “Based on available evidence, routine use of external remote patient management devices is not recommended. Implanted devices that monitor pulmonary arterial pressure and/or other parameters may be beneficial in selected patients or when used in structured programs, but the value of these devices in routine care requires further study. Future research is also warranted to better understand the cost-effectiveness of these devices.”

HF = heart failure; HFrEF = heart failure with reduced ejection fraction; LVEF = left ventricular ejection fraction, IN-TIME = INfluence of Home Monitoring on The clinical Management of heart failurE patients with impaired left ventricular function.