Remote monitoring of heart failure patients using implantable cardiac pacing devices and external sensors: results of the Insight-HF study.

AIM: The rapidly increasing prevalence and poor outcome of congestive heart failure have stimulated the development of different telemonitoring technologies. In this study, we monitored remotely self-measured body weight and blood pressure, in parallel with the data automatically transmitted by implantable cardioverter-defibrillators. The primary aim of this study was to evaluate the correlation between different parameters screened by these two telemonitoring systems. METHODS AND
RESULTS: Thirty-two patients in NYHA class III heart failure were followed for 164 ± 48 days after cardioverter-defibrillator implantation. In 29 patients, mean heart rate (MHR), resting heart rate (RHR), and patient activity (determined by implanted devices), weight and blood pressure measurements were received on 85% of all days when remote data transmissions were expected. Based on approximately 4,000 daily pairs of measurements pooled for all patients, weight inversely correlated with activity and with the difference between MHR and RHR. By contrast, blood pressure did not correlate with weight, activity, or the difference between MHR and RHR, but it correlated with MHR and RHR individually.
CONCLUSION: Body weight, patient activity, and the difference between MHR and RHR are mutually correlated and may reasonably contribute to an algorithm for predicting heart failure deterioration. Blood pressure appears to offer no additional value. As both genesis and symptoms of heart failure exacerbation are non-uniform and complex, the telemonitoring concepts for heart failure patients should employ continuous monitoring of multiple diagnostic parameters, rather than rely on a single parameter. Provided that patient compliance is strictly supervised, reliable data flow from sensors requiring patient involvement is possible.