RESULTS Device diagnostics showed strong correlation with established HF biomarkers and hemodynamic measures .
The findings from this review indicate that device diagnostic parameters predict impending HF much earlier than traditional methods of monitoring do .
Device diagnostics are also more accurate in the early prediction of HF when compared with noninvasive objective measures , particularly when multiple parameters are combined and monitored for trends .
Device diagnostics possess a distinct advantage over traditional methods of monitoring for HF because they allow clinicians to remotely monitor the status of their HF patients without relying on patient compliance for data entry and reporting .
Studies regarding the efficacy of device diagnostic parameters suggest that their integration into clinical practice will provide a more accurate and reliable mechanism for assisting clinicians in risk stratifying and predicting potential episodes of decompensated HF
BACKGROUND Traditional methods of heart failure ( HF ) management are based on reactive strategies to treat late indicators of decompensated HF .
Advances in monitoring methods have become available with the evolution of implantable cardioverter-defibrillators and cardiac-resynchronization therapy devices .
These devices provide new diagnostic data and remote monitoring capabilities that allow clinicians to proactively monitor patients for earlier signs of worsening HF .
The integration of data obtained from implantable cardioverter-defibrillator and cardiac-resynchronization therapy technology could improve outpatient HF care , potentially leading to decreased readmission rates and improved patient outcomes .
OBJECTIVE This review will synthesize the literature regarding the efficacy of device diagnostic data and the usability of the data in the clinical setting .
Integration of automatic intrathoracic fluid content measurement into clinical decision making in patients with congestive heart failure.
BACKGROUND Hospitalizations due to decompensation are a frequent problem in treating patients with congestive heart failure ( CHF ) .  Continuous impedance measurement via implantable devices may detect pulmonary fluid accumulation due to worsening CHF . An acoustic alert might allow an earlier treatment of impending decompensation . An algorithm that implemented impedance measurement into clinical decision making in treating CHF patients was evaluated . METHODS Forty-two CHF patients ( ejection fraction : 27 + /- 6 % ; New York Heart Association 2.9 + /- 0.6 ) with cardiac resynchronization therapy and automatic impedance measurements were included . Upon an alert , a stepped therapy was initiated : category ( 1 ) overt decompensation , hospitalization ; category ( 2 ) worsened CHF , increase of diuretics ; category ( 3 ) no CHF worsening , brain natriuretic peptide ( BNP ) measurement , elevated BNP : increase of diuretics , normal BNP : no specific treatment . RESULTS During 18 + /- 4 months , 45 alerts were treated according to the algorithm . Eleven category 1 alerts led to hospitalization ; 21 category 2 and 11 category 3 patients ( elevated BNP ) were treated conservatively . Two category 3 alerts ( normal BNP ) received no treatment . CONCLUSIONS Automatic impedance measurement can be integrated into CHF management . BNP measurement restricted to patients with alert but without clinical signs of worsened CHF may prevent premature therapy escalation
RESULTS Device diagnostics showed strong correlation with established HF biomarkers and hemodynamic measures .
The findings from this review indicate that device diagnostic parameters predict impending HF much earlier than traditional methods of monitoring do .
Device diagnostics are also more accurate in the early prediction of HF when compared with noninvasive objective measures , particularly when multiple parameters are combined and monitored for trends .
Device diagnostics possess a distinct advantage over traditional methods of monitoring for HF because they allow clinicians to remotely monitor the status of their HF patients without relying on patient compliance for data entry and reporting .
Studies regarding the efficacy of device diagnostic parameters suggest that their integration into clinical practice will provide a more accurate and reliable mechanism for assisting clinicians in risk stratifying and predicting potential episodes of decompensated HF
BACKGROUND Traditional methods of heart failure ( HF ) management are based on reactive strategies to treat late indicators of decompensated HF .
Advances in monitoring methods have become available with the evolution of implantable cardioverter-defibrillators and cardiac-resynchronization therapy devices .
These devices provide new diagnostic data and remote monitoring capabilities that allow clinicians to proactively monitor patients for earlier signs of worsening HF .
The integration of data obtained from implantable cardioverter-defibrillator and cardiac-resynchronization therapy technology could improve outpatient HF care , potentially leading to decreased readmission rates and improved patient outcomes .
OBJECTIVE This review will synthesize the literature regarding the efficacy of device diagnostic data and the usability of the data in the clinical setting .