Wearable Devices for Monitoring and Management of Heart Failure (Preprint)

Abstract

BACKGROUND Heart failure (HF) represents a significant global health challenge, affecting millions and leading to substantial morbidity and mortality. Wearable devices equipped with sensors and wireless connectivity offers a revolutionary approach to extensive heart failure treatment. These devices facilitate continuous monitoring, enabling early decompensation detection and real-time feedback. With the potential to revolutionize heart failure management, wearables offer a promising avenue for preventing exacerbations and improving patients' overall quality of life. This paper provides critical examinations and summaries of existing research studies with an in-depth analysis of not only the individual studies but also the larger patterns that have emerged with recent advancements in wearable technology for heart failure management as well as their clinical effectiveness, features, and functions of these devices for practice change A systematic and comprehensive search was performed on English papers that investigated the development, utilization, and impact of wearable devices in the context of heart failure management. The search encompassed a range of electronic databases. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines was used. We identified 1264 articles, of which 270 were eligible for full-text screening. A total of 68 full-text articles were included in the review, revealing a multifaceted landscape of monitoring and management in the context of heart failure. Within this comprehensive body of literature, we identified ten distinct monitoring and management domains: cardiovascular parameters, biomarkers, medication adherence, physical activity, early detection and decompensation, telehealth interventions, wearables, and remote monitoring technologies. Notably, there was a clear trend of increasing research activity across these domains, with a particularly pronounced acceleration observed in recent years, notably in the fields of continuous monitoring of vital signs and remote monitoring technologies. This systematic scoping review offers a comprehensive perspective on recent advances in wearable devices for the monitoring and management of heart failure, shedding light on the diverse array of monitoring domains and approaches utilized in research. The findings of this review underscore the considerable potential for the effectiveness of various monitoring domains, with notable strengths observed in medication monitoring, cardiac function assessment, and digital health applications. As we move forward, future investigations should consider adapting relevant hospital-based diagnostic tools for home use, exploring their potential benefits in a home setting. Furthermore, there is a promising avenue for research to integrate multiple home-monitoring domains, thereby facilitating comprehensive multi-parameter decision-making and enabling personalized clinical decision support to enhance the care of heart failure patients. OBJECTIVE This paper provides critical examinations and summaries of existing research studies with an in-depth analysis of not only the individual studies but also the larger patterns that have emerged with recent advancements in wearable technology for heart failure management as well as their clinical effectiveness, features, and functions of these devices for practice change METHODS A systematic and comprehensive search was performed on English papers that investigated the development, utilization, and impact of wearable devices in the context of heart failure management. The search encompassed a range of electronic databases. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines was used. RESULTS We identified 1264 articles, of which 270 were eligible for full-text screening. A total of 68 full-text articles were included in the review, revealing a multifaceted landscape of monitoring and management in the context of heart failure. Within this comprehensive body of literature, we identified ten distinct monitoring and management domains: cardiovascular parameters, biomarkers, medication adherence, physical activity, early detection and decompensation, telehealth interventions, wearables, and remote monitoring technologies. Notably, there was a clear trend of increasing research activity across these domains, with a particularly pronounced acceleration observed in recent years, notably in the fields of continuous monitoring of vital signs and remote monitoring technologies. CONCLUSIONS This systematic scoping review offers a comprehensive perspective on recent advances in wearable devices for the monitoring and management of heart failure, shedding light on the diverse array of monitoring domains and approaches utilized in research. The findings of this review underscore the considerable potential for the effectiveness of various monitoring domains, with notable strengths observed in medication monitoring, cardiac function assessment, and digital health applications. As we move forward, future investigations should consider adapting relevant hospital-based diagnostic tools for home use, exploring their potential benefits in a home setting. Furthermore, there is a promising avenue for research to integrate multiple home-monitoring domains, thereby facilitating comprehensive multi-parameter decision-making and enabling personalized clinical decision support to enhance the care of heart failure patients.