Implantable sensors for heart failure monitoring

Over the last decade, there has been a surge in the implantations of devices for cardiac resynchronization therapy (CRT), with increasing recognition of their value in the management of medically refractory heart failure (HF). With this exponential growth, the need to offer the best quality of care after implantation has entailed an increase in healthcare spending. Frequent in-office follow-ups are limited by the immense healthcare cost, while emergency hospitalizations for acute decompensation of HF further contribute to the burden. Implantable sensors in the CRT device offer a unique opportunity for continuous monitoring of a patient's clinical HF status by measuring cardiac rhythm, intracardiac pressures, cardiac events, and physical activity, as well as detecting any device malfunction. Detecting early signs of a deteriorating clinical condition allows prompt preemptive medical intervention to optimize HF management. As a result, not only healthcare professionals will benefit from a reduction in hospitalizations and routine in-office follow-ups, but also patients will benefit from efficient management of their HF. This review highlights the latest available device-based remote monitoring systems and the most up-to-date evidence for the use of remote monitoring in CRT.