Digital Technologies in Heart Failure Management

Heart failure (HF) is the leading cause of hospital readmission for patients over 65 years old in the United States. HF is a unique clinical condition requiring frequent monitoring of objective patient variables that cannot be accomplished by office visits alone. With the advent of smartphones, Bluetooth, and Wi-Fi technologies, an opportunity arose for the digital management of HF patients. This paper reviews the current digital technologies available in HF management and future directions that have the potential to change clinical practice. Implantable, wireless pulmonary artery hemodynamic monitoring systems, such as CardioMEMS, have shown strong evidence in reducing HF hospitalization. Wearable activity trackers can also be used to track functional status and rhythm abnormalities in HF; however, evidence that these devices improve clinical outcomes in HF is lacking. There is currently promise in non-invasive measurements of pulmonary congestion and cardiovascular hemodynamics using Remote Dieletric Sensing Technologies (ReDS), seismocardiography, and ballistocardiography, but these technologies are not routinely used in clinical practice. Future applications of digital technologies will likely incorporate personalized medicine to improve clinical care. Digital management of HF has emerged as a promising avenue for prevention of HF hospitalization. Although some technologies have shown to improve clinical outcomes, further studies are needed on currently existing technologies to assess their viability as tools in preventing rehospitalization. It is important for the clinician to understand the limitations of digital technologies, as well as their potential to worsen healthcare disparities.