APRIL - 20228In My OpinionHeart failure is a disease of the heart muscle that results in weakening of its pumping function. Put simply, heart failure means the heart is not able to pump enough blood to meet the body's needs. In fact, heart failure is a common condition, affecting as many as five to six million U.S. adults. Patients with heart failure often struggle with related conditions or symptoms that can be challenging to develop an effective treatment plan for and have a major impact how they feel day-to-day. The care of these patients is complex, time and labor intensive requiring a specialized team of experts to appropriately take care of them. In the USA, the total cost of care (direct and indirect costs) for HF in 2020 was estimated at $43.6 billion. On in-dept review it is clear that hospitalization costs are the key driver of heart failure-related costs, which has led to great emphasis on interventions to reduce admissions and readmissions. One such intervention is the application of remote monitoring technology. However, the coronavirus disease-2019 (COVID-19) pandemic has had a significant impact on the way we care for patients, particularly those with heart failure (HF) who are at higher risk for morbidity and mortality. Prior to the pandemic many of these patients' care would be provided in person either in the clinic or in the hospital. With the advent of the COVID19 pandemic and the need for reduced in-person visits, adoption of telehealth has been instrumental in continuing to care for this vulnerable patient population. We now have a series of remote monitoring technologies available that can enhance the care we provide. These technologies allow for close monitoring for early signs of heart failure and assist the care team with therapeutic interventions which result in reduction in risk of admission and allows for ongoing management without the patient being seen in person. Remote monitoring for heart failure patients is available in 3 platforms. The most common and easiest to implement is a structured telephone support service with frequent calls made to patients to review for changes in heart failure symptoms, weight, medication compliance, and the medical plan adjusted based on the patient's report. Another platform of clinical importance is the use of invasive devices implanted in the pulmonary (lung) artery solely to monitor surrogates of worsening heart failure. These devices can predict a heart failure episode by monitoring changes in lung pressure i.e. the increased pressure of blood flowing from the heart to the lungs through the pulmonary artery can signal worsening heart failure -- up to 2 weeks before the patient notices any signs or symptoms such as shortness of breath or weight gain. Changes in the pressures are monitored remotely from the comfort the patient's home using the CardioMEMSTMHF System (Abbott). Based on the data the care team gets from the system, adjustments are made to the patient's medications or recommend lifestyle changes without needing a visit to the hospital or clinic. The CardioMEMS system is clinically proven to Ugochukwu O. Egolum, MD, Chief, Department of Cardiology, Northeast Georgia Health SystemByTHE APPLICATION OF REMOTE MONITORING TECHNOLOGY IN THE MANAGEMENT OF HEART FAILURE PATIENTS
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