## 4 Clinical Applications of AI to CHF Management
### Internet of Things (IoT)  
The concept of the Internet of Things (IoT) is based on the use of various electronic sensors embedded in objects that are regularly part of our environment by means of a common software platform [51]. From a technical point of view, it consists of three layers; a sensing layer is the patient's particular sensor. A transport layer comprises connectors transporting data from sensors to the remote device; an application layer is a server. IoT has considerable potential for telemedicine and for patients self-monitoring. (Figure 2) Leveraging IoT, physicians can now monitor various vital signs and select clinical parameters to forecast medical emergencies. The most recent technology establishes a global network of machines and gadgets individually equipped with software that allows them to exchange and communicate information through the Internet. The critical feature of IoT is that it can transform anything into an intelligent, bright object by giving it the capacity to act, communicate, sense, and compute. The application of IoT to smart wearable technology is useful for the management of chronic heart failure patients providing a continuous flow of healthcare data, such as temperature, saturation, cardiac frequency, blood pressure, respiration rate, patient activities, and rhythm abnormalities. This allows early identification of worsening patient status, providing clinicians with a more comprehensive view of a patient's health compared with the traditional sporadic measures captured by office visits and hospitalisations. Several randomised trials have assessed the value of remote non-invasive telemonitoring interventions in HF, with mixed results. For example, one miniature smartwatch-integrated sphygmomanometer (Omron(tm) HeartGuide) has met the American National Standards Institute criteria for measuring blood pressure by oscillometry across a range of blood pressures. The use of such a wearable device may facilitate optimal adjustment of antihypertensive or heart failure medication, monitoring of iatrogenic hypotension, and support persistence with therapy [52]. A summary of common commercial smart wearables available is available in Table 3 Not only wearable devices are available for remote monitoring and management of patients with heart failure. Platforms like Medicomp Quippi [[https://medicomp.com/quippe-clinical-data-engine/](https://medicomp.com/quippe-clinical-data-engine/)]([https://medicomp.com/quippe-clinical-data-engine/](https://medicomp.com/quippe-clinical-data-engine/)) accessed on 5 April 2023, Royal Philips' HealthSuite digital platform [53] help healthcare providers personalise treatment plans and drug dosing. In addition to platforms that facilitate the management of the patient with chronic heart failure, predict tools are able to estimate the risk of developing acute complications, such as the Zebra Medical Vision's Risk Assessment platform [[http://www.zebra-med.com/accessed](http://www.zebra-med.com/accessed)]([http://www.zebra-med.com/accessed](http://www.zebra-med.com/accessed)) on 5 April 2023, CarePredict's Tempo platform [[https://www.carepredict.com/accessed](https://www.carepredict.com/accessed)]([https://www.carepredict.com/accessed](https://www.carepredict.com/accessed)) on 5 April 2023. Each platform uses machine learning algorithms to predict the risk of acute clinical complications in heart failure patients based on imaging, electronic health record data and lab results.