Wearable remote monitoring in heart failure care - where do we stand?

Heart failure (HF) is a highly prevalent and increasingly present condition with a huge impact on several global healthcare dimensions. HF hospitalizations are particularly burdensome and are among the leading concerns of HF health providers, both related to the economic impact and the association with adverse outcomes. In Europe, the (re)admission rate at 12 months varies from 25.9% to 44% and in the ESC Heart Failure Long Term Registry a medium 5.5% in-hospital mortality rate was observed(ranging from 1.8% to 36.1% according to presenting clinical phenotype), highlighting the insufficiency of current approaches to disease management. According to Gouveia et al., in Portugal, HF hospitalizations portended 39% of direct HF-related costs in 2014, corroborating the economic burden of HF hospitalization among us. Telehealth has been embraced as a practice to mitigate HF effects by allowing upstream detection of worsening clinical status. This home-rendered medical care strategy encompasses a range of methods, from structured self-monitoring telephone-based programs to sophisticated device remote monitoring. A promising methodology that might be conceptually superior to standalone clinical appointments, albeit with inherent limitations