title: A critical review on telemonitoring in heart failure.
abstract: Morbidity and mortality remain high in heart failure despite considerable progress achieved with medical therapy and electrical devices. A multidisciplinary approach is actually strongly recommended. In order to provide optimal care to the ever-growing population of patients with heart failure, telemonitoring has been proposed as a modality to improve usual care. The aim of this review is to provide an overview of the existing evidence on telemonitoring in HF. Despite two major meta-analyses with favourable results, two recent, large, multicentre, randomized controlled trials, one with a sophisticated technical remote telemonitoring approach (TIM-HF) in stable chronic HF and the other with a comprehensive telephone-based interactive voice-response monitoring (Tele-HF) in patients recently hospitalized for heart failure, have been performed and both failed to demonstrate a clinical benefit for telemonitoring. Newer technologies or other modalities, such as collaboration between a general practitioner and a heart failure clinic facilitated by telemonitoring should be further evaluated. Dedicated telemonitoring for heart failure may be a practical adjunct in selective centres and patients, on top of usual care, including education and a multidisciplinary approach. However, prior to being accepted as a standard of care, more evidence from large, randomized clinical trials is required.
authors.affiliation: Cliniques Universitaires St Luc, Bruxelles, Belgium. Olivier.gurne@uclouvain.be
authors.forename: Olivier
authors.initials: O
authors.lastname: Gurné
authors.forename: Viviane
authors.initials: V
authors.lastname: Conraads
authors.forename: Luc
authors.initials: L
authors.lastname: Missault
authors.forename: Wilfried
authors.initials: W
authors.lastname: Mullens
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Vachierys
authors.forename: Walter
authors.initials: W
authors.lastname: Van Mieghem
authors.forename: Walter
authors.initials: W
authors.lastname: Droogne
authors.forename: Anne-Catherine
authors.initials: AC
authors.lastname: Pouleur
authors.forename: Pierre
authors.initials: P
authors.lastname: Troisfontaine
authors.forename: Sandrine
authors.initials: S
authors.lastname: Huez
authors.forename: Eric
authors.initials: E
authors.lastname: Nellessens
authors.forename: Beatrice
authors.initials: B
authors.lastname: Peperstraete
authors.forename: Philippe
authors.initials: P
authors.lastname: Blouardo
authors.forename: Johan
authors.initials: J
authors.lastname: Vanhaecke
authors.forename: David
authors.initials: D
authors.lastname: Raes
mesh_terms: D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D015201:Meta-Analysis as Topic; D008991:Monitoring, Physiologic / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome