title: Remote monitoring of heart failure patients using implantable cardiac pacing devices and external sensors: results of the Insight-HF study.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Internal Medicine and Cardiology, German Heart Institute Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. ann.lieback@charite.de
authors.forename: Ann
authors.initials: A
authors.lastname: Lieback
authors.forename: Jochen
authors.initials: J
authors.lastname: Proff
authors.forename: Kai
authors.initials: K
authors.lastname: Wessel
authors.forename: Eckart
authors.initials: E
authors.lastname: Fleck
authors.forename: Stephan
authors.initials: S
authors.lastname: Götze
mesh_terms: D056044:Actigraphy / Q000295:instrumentation*; D000368:Aged; D000465:Algorithms; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000295:instrumentation*; D001835:Body Weight; D058409:Cardiac Resynchronization Therapy Devices; D017147:Defibrillators, Implantable; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005858:Germany; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006339:Heart Rate; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011237:Predictive Value of Tests; D012815:Signal Processing, Computer-Assisted; D013686:Telemetry / Q000295:instrumentation*; D013997:Time Factors; D014159:Transducers