Heart failure is a very complex disease. It manifests itself in numerous symptoms and often interfaces with other illnesses, such as diabetes, lung and kidney diseases. Therefore, it is not easy to recognize if and when the heart condition is worsening. In addition, half of those affected often do not notice any symptoms for a long time before decompensation (waterlogging in the lungs) – even though the pressure conditions in the heart chambers, pulmonary circulation or other areas of the body change days beforehand. Then, however, even small occasions such as a cold, lavish meals or a forgotten medication are enough for the lung pressure to rise, water to build up in the lungs and acute shortness of breath to develop, which can become life-threatening. However, an acute increase in blood or lung pressure, spontaneous changes in heart rate or weight can provide important clues to impending decompensation. If these signals are detected early enough, timely countermeasures (e.g. medication) can be taken and hospitalization can often be avoided. With the help of daily monitoring of relevant health values, doctors can keep a close eye on your condition and ensure that abnormalities are seen and treated in good time.

If you have an implantable ICD or CRT device, your physician will provide you with a transmitter to take home, which can be used to regularly transmit your health data from the implant to a cardiological telemonitoring center (TMC). If you do not have an implant but have been hospitalized for decompensation within the last 12 months, you will receive a set of external devices to transmit your body weight, blood pressure, heart rate, ECG, and your own health assessment from home. The telemonitoring center works closely with your physician. The evaluation of your health data by the telemonitoring center takes place on weekdays, but can also be extended to weekends and holidays if indicated. The telemonitoring center forwards any abnormalities detected to your attending physician so that he or she can take prompt action if necessary.

In order to map the course of treatment holistically, health information is centrally recorded on a digital monitoring platform, the inCareNet platform. InCareNet was developed by leading heart failure experts and makes it possible to record, coordinate and structure examinations and treatment steps of all participating physicians across sites and disciplines. The solution is based on the latest medical and scientific findings and guidelines. The aim is to improve the quality of treatment.

For implant patients, the monitored health and ICD or CRT data are transmitted automatically and event-related from the implant via a transmitter from home to the responsible telemonitoring center, which views the data.

Your attending physician will provide you with a scale, a blood pressure monitor, a mobile ECG recorder to be placed on your chest, and a tablet. This enables you to document your weight, blood pressure, heart rate and ECG and your health assessment independently on a daily basis and – in compliance with the usual data protection regulations – to transmit them to the responsible monitoring center.

The TMC evaluates – both implant data and data from external device set – and also notifies the responsible physician if necessary. The necessary equipment is provided by your supervising physician as part of the telemonitoring. The costs for this are covered by your health insurance. Telemonitoring is not an emergency information system. In case of emergency or discomfort, it is imperative that you seek medical treatment and contact the available medical facilities.

Monitoring is subject to German data protection requirements, which are among the most comprehensive and stringent in the world. All of the data transfers are done on a secure and encrypted way, harmonized with the European GDRP regulation.

Implant patients (examples of data)

• ICD / CRT and electrode function
• Possible water accumulation in the lungs (device-dependent resistance measurement)
• Cardiac arrhythmias (intracardiac ECGs)
• Indications of deterioration of health status

Patients with external devices

• ECG recording (mobile ECG recorder)
• Body weight (Bluetooth scale)
• Blood pressure (Bluetooth blood pressure monitor)
• Self-assessment of health status (tablet)

HF Telemonitoring is open to patients who

• have moderate or severe heart failure (NYHA class II or III)
• Have reduced cardiac output (pumping efficiency of < 40%)
• wear an active cardiac rhythm implant (ICD, CRT pacemaker or CRT defibrillator) with monitoring function or
• do not wear an implant but have been hospitalized for decompensation within the last 12 months.