Optimizing heart failure therapy with implantable sensors

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Heart failure (HF)-related hospitalization is associated with significant mortality and morbidity and can be prevented by early intervention. Implantable sensors detect early pathophysiological changes in HF, using an accelerometer, a paced electrogram, impedance and pressure sensors in implanted intracardiac leads, or stand-alone devices. Such sensors monitor daily activity, QT and ST intervals, pulmonary fluid, and intracardiac pressures at various points. Sensor data are available either by patient’s or physician’s regular interrogation, or using remote patient monitoring. Different sensors have different levels of sensitivity and specificity for HF detection, and they have the ability to antedate HF exacerbation and thereby allow for the initiation of intervention to avert decompensation. Clinical studies suggest that alone or in combination, such sensors have a greater beneficial impact than conventional therapy on acute HF outcome.