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Telemonitoring in Chronic Heart Failure
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Telemonitoring in Chronic Heart Failure

A special issue of Sensors (ISSN 1424-8220). This special issue belongs to the section "Biomedical Sensors".

Deadline for manuscript submissions: closed (1 May 2021) | Viewed by 23460

Special Issue Editors

Dr. Jasper J. Brugts

E-Mail Website
Guest Editor
Department of Cardiology, Thorax Center, Erasmus University Medical Center, 3015GD Rotterdam, The Netherlands
Interests: cardiology; heart failure; advanced heart failure therapy; e-health
Special Issues, Collections and Topics in MDPI journals
Dr. Dominic A.M.J. Theuns

E-Mail Website
Guest Editor
Erasmus MC, 3000CA Rotterdam, The Netherlands
Interests: cardiology; cardiac implantable electronic devices; cardiac resynchronisation therapy; electrophysiology
MD Sumant P. Radhoe

E-Mail Website
Guest Editor
Erasmus MC, 3000CA Rotterdam, The Netherlands
Interests: cardiology; heart failure; advanced heart failure therapy; e-health
MD Jesse F. Veenis

E-Mail Website
Guest Editor
Erasmus MC, 3000CA Rotterdam, The Netherlands
Interests: cardiology; heart failure; advanced heart failure therapy; e-health

Special Issue Information

Dear Colleagues,

With the rapidly increasing prevalence and incidence of chronic heart failure (CHF), the burden of CHF on healthcare systems worldwide is expected to grow rapidly. The main burden in these heart failure (HF) patients is the need for repeated hospitalizations due to decompensated HF, which has enormous impact on hospital resources and delivery of standard care. It is known that HF prognosis worsens with every hospitalization due to myocardial and renal damage. It is therefore inevitable to develop effective methods to remotely monitor patients in order to timely detect deterioration and prevent heart failure hospitalizations which will in turn lead to better prognosis on the one hand and relief of CHF burden on the other hand. Efforts are focussing on keeping the patients out of the hospital. These methods are also referred to as telemonitoring and several methods have been proposed and tested in clinical studies over the past decades.

Telemonitoring can roughly be divided into monitoring of non-invasive physical parameters reflecting clinical congestion such as blood pressure and weight, monitoring by cardiac implantable electronic devices such as ICD’s and pacemakers and monitoring by (more) invasive sensors measuring intravascular or cardiac pressures.

This special issue will focus on the efficacy of all available techniques and methods of telemonitoring by providing separate in-depth reviews in the area of heart failure. Furthermore, a view on future perspectives will be provided in this aspect of heart failure management. We strongly encourage scientists worldwide to submit their work relevant to the subject of this special issue. Topics of particular interest include, but are not limited to, the following:

  • Developments in heart failure telemonitoring
  • E-Health in heart failure
  • Artificial intelligence in telemedicine in heart failure

Dr. Jasper J. Brugts
Dr. Dominic A.M.J. Theuns
MD Sumant P. Radhoe
MD Jesse F. Veenis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Sensors is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • heart failure
  • remote monitoring
  • telemonitoring
  • telemedicine
  • e-health
  • cardiac implantable electronic devices

Published Papers (6 papers)

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Research

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13 pages, 1266 KiB  
Article
Predictors of Hospital Mortality in Patients with Acute Coronary Syndrome Complicated by Cardiogenic Shock
by Gábor Tamás Szabó, András Ágoston, Gábor Csató, Ildikó Rácz, Tamás Bárány, Gábor Uzonyi, Miklós Szokol, Balázs Sármán, Éva Jebelovszki, István Ferenc Édes, Dániel Czuriga, Rudolf Kolozsvári, Zoltán Csanádi, István Édes and Zsolt Kőszegi
Sensors 2021, 21(3), 969; https://doi.org/10.3390/s21030969 - 1 Feb 2021
Cited by 5 | Viewed by 2575
Abstract
As demonstrated by earlier studies, pre-hospital triage with trans-telephonic electrocardiogram (TTECG) and direct referral for catheter therapy shows great value in the management of out-of-hospital chest pain emergencies. It does not only improve in-hospital mortality in ST-segment elevation myocardial infarction, but it has [...] Read more.
As demonstrated by earlier studies, pre-hospital triage with trans-telephonic electrocardiogram (TTECG) and direct referral for catheter therapy shows great value in the management of out-of-hospital chest pain emergencies. It does not only improve in-hospital mortality in ST-segment elevation myocardial infarction, but it has also been identified as an independent predictor of higher in-hospital survival rate. Since TTECG-facilitated triage shortens both transport time and percutaneous coronary intervention (PCI)-related procedural time intervals, it was hypothesized that even high-risk patients with acute coronary syndrome (ACS) and cardiogenic shock (CS) might also benefit from TTECG-based triage. Here, we decided to examine our database for new triage- and left ventricular (LV) function-related parameters that can influence in-hospital mortality in ACS complicated by CS. ACS patients were divided into two groups, namely, (1) hospital death patients (n = 77), and (2) hospital survivors (control, n = 210). Interestingly, TTECG-based consultation and triage of CS and ACS patients were confirmed as significant independent predictors of lower hospital mortality risk (odds ratio (OR) 0.40, confidence interval (CI) 0.21–0.76, p = 0.0049). Regarding LV function and blood chemistry, a good myocardial reperfusion after PCI (high area at risk (AAR) blush score/AAR LV segment number; OR 0.85, CI 0.78–0.98, p = 0.0178) and high glomerular filtration rate (GFR) value at the time of hospital admission (OR 0.97, CI 0.96–0.99, p = 0.0042) were the most crucial independent predictors of a decreased risk of in-hospital mortality in this model. At the same time, a prolonged time interval between symptom onset and hospital admission, successful resuscitation, and higher peak creatine kinase activity were the most important independent predictors for an increased risk of in-hospital mortality. In ACS patients with CS, (1) an early TTECG-based teleconsultation and triage, as well as (2) good myocardial perfusion after PCI and a high GFR value at the time of hospital admission, appear as major independent predictors of a lower in-hospital mortality rate. Full article
(This article belongs to the Special Issue Telemonitoring in Chronic Heart Failure)
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Review

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18 pages, 3073 KiB  
Review
Invasive Devices and Sensors for Remote Care of Heart Failure Patients
by Sumant P. Radhoe, Jesse F. Veenis and Jasper J. Brugts
Sensors 2021, 21(6), 2014; https://doi.org/10.3390/s21062014 - 12 Mar 2021
Cited by 22 | Viewed by 4295
Abstract
The large and growing burden of chronic heart failure (CHF) on healthcare systems and economies is mainly caused by a high hospital admission rate for acute decompensated heart failure (HF). Several remote monitoring techniques have been developed for early detection of worsening disease, [...] Read more.
The large and growing burden of chronic heart failure (CHF) on healthcare systems and economies is mainly caused by a high hospital admission rate for acute decompensated heart failure (HF). Several remote monitoring techniques have been developed for early detection of worsening disease, potentially limiting the number of hospitalizations. Over the last years, the scope has been shifting towards the relatively novel invasive sensors capable of measuring intracardiac filling pressures, because it is believed that hemodynamic congestion precedes clinical congestion. Monitoring intracardiac pressures may therefore enable clinicians to intervene and avert hospitalizations in a pre-symptomatic phase. Several techniques have been discussed in this review, and thus far, remote monitoring of pulmonary artery pressures (PAP) by the CardioMEMS (CardioMicroelectromechanical system) HF System is the only technique with proven safety as well as efficacy with regard to the prevention of HF-related hospital admissions. Efforts are currently aimed to further develop existing techniques and new sensors capable of measuring left atrial pressures (LAP). With the growing body of evidence and need for remote care, it is expected that remote monitoring by invasive sensors will play a larger role in HF care in the near future. Full article
(This article belongs to the Special Issue Telemonitoring in Chronic Heart Failure)
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18 pages, 2319 KiB  
Review
Early Detection of Fluid Retention in Patients with Advanced Heart Failure: A Review of a Novel Multisensory Algorithm, HeartLogicTM
by Michelle Feijen, Anastasia D. Egorova, Saskia L. M. A. Beeres and Roderick W. Treskes
Sensors 2021, 21(4), 1361; https://doi.org/10.3390/s21041361 - 15 Feb 2021
Cited by 6 | Viewed by 3253
Abstract
Heart failure (HF) hospitalisations due to decompensation are associated with shorter life expectancy and lower quality of life. These hospitalisations pose a significant burden on the patients, doctors and healthcare resources. Early detection of an upcoming episode of decompensation may facilitate timely optimisation [...] Read more.
Heart failure (HF) hospitalisations due to decompensation are associated with shorter life expectancy and lower quality of life. These hospitalisations pose a significant burden on the patients, doctors and healthcare resources. Early detection of an upcoming episode of decompensation may facilitate timely optimisation of the ambulatory medical treatment and thereby prevent heart-failure-related hospitalisations. The HeartLogicTM algorithm combines data from five sensors of cardiac implantable electronic devices into a cumulative index value. It has been developed for early detection of fluid retention in heart failure patients. This review aims to provide an overview of the current literature and experience with the HeartLogicTM algorithm, illustrate how the index can be implemented in daily clinical practice and discuss ongoing studies and potential future developments of interest. Full article
(This article belongs to the Special Issue Telemonitoring in Chronic Heart Failure)
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22 pages, 13036 KiB  
Review
Remote Monitoring in Chronic Heart Failure Patients: Is Non-Invasive Remote Monitoring the Way to Go?
by Jesse F. Veenis, Sumant P. Radhoe, Petra Hooijmans and Jasper J. Brugts
Sensors 2021, 21(3), 887; https://doi.org/10.3390/s21030887 - 28 Jan 2021
Cited by 20 | Viewed by 4830
Abstract
Heart failure (HF) is a major health care issue, and the incidence of HF is only expected to grow further. Due to the frequent hospitalizations, HF places a major burden on the available hospital and healthcare resources. In the future, HF care should [...] Read more.
Heart failure (HF) is a major health care issue, and the incidence of HF is only expected to grow further. Due to the frequent hospitalizations, HF places a major burden on the available hospital and healthcare resources. In the future, HF care should not only be organized solely at the clinical ward and outpatient clinics, but remote monitoring strategies are urgently needed to guide, monitor, and treat chronic HF patients remotely from their homes as well. The intuitiveness and relatively low costs of non-invasive remote monitoring tools make them an appealing and emerging concept for developing new medical apps and devices. The recent COVID-19 pandemic and the associated transition of patient care outside the hospital will boost the development of remote monitoring tools, and many strategies will be reinvented with modern tools. However, it is important to look carefully at the inconsistencies that have been reported in non-invasive remote monitoring effectiveness. With this review, we provide an up-to-date overview of the available evidence on non-invasive remote monitoring in chronic HF patients and provide future perspectives that may significantly benefit the broader group of HF patients. Full article
(This article belongs to the Special Issue Telemonitoring in Chronic Heart Failure)
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Other

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12 pages, 1787 KiB  
Viewpoint
Remote Monitoring of Heart Failure in Patients with Implantable Cardioverter-Defibrillators: Current Status and Future Needs
by Dominic A. M. J. Theuns, Sumant P. Radhoe and Jasper J. Brugts
Sensors 2021, 21(11), 3763; https://doi.org/10.3390/s21113763 - 28 May 2021
Cited by 11 | Viewed by 3629
Abstract
The management of heart failure remains challenging despite evidence-based medical and pharmacological advances, especially in the ambulatory setting. There is an urgent need to develop strategies to reduce hospitalizations and readmission rates due to heart failure. Frequent monitoring of high-risk patients is imperative, [...] Read more.
The management of heart failure remains challenging despite evidence-based medical and pharmacological advances, especially in the ambulatory setting. There is an urgent need to develop strategies to reduce hospitalizations and readmission rates due to heart failure. Frequent monitoring of high-risk patients is imperative, and with the development of wireless and remote technology, frequent monitoring is now possible via remote monitoring. Nowadays, remote management of patients with cardiac implantable electronic devices is being increasingly adopted and integrated into clinical practice. Several clinical trials studied the impact of remote monitoring on clinical outcomes in patients with implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization defibrillators (CRT-Ds). This point of view will focus on the remote monitoring of ICDs and CRT-Ds in patients with heart failure and discusses whether remote monitoring can be used as a potential instrument for the early identification of patients at risk of worsening heart failure. Full article
(This article belongs to the Special Issue Telemonitoring in Chronic Heart Failure)
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15 pages, 2859 KiB  
Viewpoint
Clinical Update of the Latest Evidence for CardioMEMS Pulmonary Artery Pressure Monitoring in Patients with Chronic Heart Failure: A Promising System for Remote Heart Failure Care
by Jasper J. Brugts, Sumant P. Radhoe, Dilan Aydin, Dominic A. Theuns and Jesse F. Veenis
Sensors 2021, 21(7), 2335; https://doi.org/10.3390/s21072335 - 27 Mar 2021
Cited by 13 | Viewed by 4097
Abstract
The CardioMEMS pulmonary artery (PA) monitoring system placed in the left lower lobe pulmonary artery is capable of measuring pulmonary artery pressure remotely as a surrogate of intracardiac filling pressures and volume status. The technique is safe and reliable. By using remote PA [...] Read more.
The CardioMEMS pulmonary artery (PA) monitoring system placed in the left lower lobe pulmonary artery is capable of measuring pulmonary artery pressure remotely as a surrogate of intracardiac filling pressures and volume status. The technique is safe and reliable. By using remote PA monitoring for proactive medical interventions, there is a growing body of clinical evidence for a substantial, robust reduction in HF hospitalizations in various populations (clinical trial setting, post-marketing studies and real-world experiences). This review summarizes the clinical evidence, outlines future perspectives, and aims for remote patient care in heart failure using CardioMEMS. Full article
(This article belongs to the Special Issue Telemonitoring in Chronic Heart Failure)
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