Current and Future Landscape of Remote Hemodynamic Monitoring

J Card Fail. 2025 Nov;31(11):1731-1742. doi: 10.1016/j.cardfail.2025.09.007.

ABSTRACT

Heart failure remains a leading cause of morbidity, mortality, and health care costs in the United States. Traditional management based on intermittent clinic visits and subjective symptom reporting often fails to detect early decompensation. Remote monitoring technologies-both invasive and noninvasive-are emerging as transformative tools for continuous, real-world surveillance of physiological parameters to guide heart failure management. This review provides a comprehensive overview of the current and evolving landscape of remote hemodynamic monitoring, including left atrial, pulmonary artery, and inferior vena cava pressure sensors, as well as cardiovascular implantable electronic devices and wearable systems. Devices such as the CardioMEMS and Cordella have demonstrated decreases in heart failure hospitalizations and improvements in quality of life through hemodynamic-guided therapy. Noninvasive technologies, including patch-based sensors, wearable monitors, and artificial intelligence-driven voice analysis platforms, show promise for broader scalability. Despite demonstrated benefits, adoption remains limited owing to data integration challenges, reimbursement barriers, and a lack of standardized clinical workflows. To fully realize the potential of remote monitoring, strategies must focus on patient engagement, closed-loop feedback systems, integration with electronic health records, and personalized algorithms. A tiered approach that matches monitoring intensity to disease severity may optimize outcomes and transform heart failure care into a proactive, patient-centered model.

PMID:41233030 | DOI:10.1016/j.cardfail.2025.09.007