Chronic heart failure (CHF) is a frequent syndrome with an increasing prevalence. It is a frequent cause of impeding symptoms, has a negative prognosis and absorbs about two percent of the budgets of health-care systems in the industrialized nations.
Optimal management of patients with chronic heart failure has to detect emerging symptoms of a beginning hemodynamic imbalance in time and to administer an appropriate therapy in order to avoid decompensation and hospital admission. Telemonitoring of physiological and clinical parameters supplies valuable information to improve health care of these patients.
The TeleMedical Centre of Brandenburg provides continuous telemonitoring of multiple disease-relevant parameters to 40 patients since more than 1 year. A user-friendly home based electronic device registers weight, blood pressure, heart rate and rhythm by means of ECG, ventilation frequency and oxygen saturation of the blood. In addition, the patient uses a schematic code to enter details on his subjective state of health, changes of medication and an optional contact request. Once per day the information is sent via e-mail to the Telemedical Centre where it is evaluated. If the critical limits of individually defined parameters are crossed the primary care provider is promptly notified by fax. So treatment can be adjusted before heartfailure deteriorates and hospital admissions becomes necessary.
Feasibility and effectiveness of the continuous telemonitoring of multiple disease-relevant parameters were evaluated. Patients with CHF (NYHA III-IV) with at least one hospital admission due to acute decompensation within in the preceding year were enrolled in our study. After receiving an in hospital optimum treatment telemonitoring was started immediately after discharge. Patients were supplied with a Telemonitoring System in order to record the above described multiple parameters daily. Data were monitored daily and assessed by specialized physicians whether defined thresholds values were exceeded. An information about imminent hemodynamic imbalance was immediately sent to the responsible general practitioner by fax-transmission.