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• RM has emerged as a promising method for monitoring patients with HF. • RM can be used at different stages of HF, not only after AHF hospitalization. • Data on the benefits of RM in HF remain ambivalent, and gaps in evidence persist. Heart failure is a chronic condition that affects millions of people worldwide and is associated with high morbidity and mortality. Remote monitoring, which includes the use of non-invasive connected devices, cardiac implantable electronic devices and haemodynamic monitoring systems, has the potential to improve outcomes for patients with heart failure. Despite the conceptual and clinical advantages, there are still limitations in the widespread use of these technologies. Moreover, a significant proportion of studies evaluating the benefit of remote monitoring in heart failure have focused on the limited area of prevention of rehospitalization after an episode of acute heart failure. A group of experts in the fields of heart failure and digital health worked on this topic in order to provide a practical paper for the use of remote monitoring in clinical practice at the different stages of the heart failure syndrome: (1) discovery of heart failure; (2) acute decompensation of chronic heart failure; (3) heart failure in stable period; and (4) advanced heart failure. A careful and critical analysis of the available literature was performed with the aim of providing caregivers with some recommendations on when and how to use remote monitoring in these different situations, specifying which variables are essential, optional or useless. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to assess single and dual-chamber pacemakers with a view to updating their reimbursement conditions by French National Health Insurance. Methods: We performed a critical appraisal of the clinical literature (2002 – 2008) which was then submitted to a multidisciplinary working group of 10 health professionals for discussion. Manufacturers’ application files were also consulted. Results: We analyzed 1 health technology assessment, 1 meta-analysis, 3 guidelines and 3 randomised controlled trials providing data on more than 7000 patients with atrio-ventricular blocks (“AVB”) and/or sick sinus syndrome (“SSS”). Pacing mode did not reduce mortality or heart failure hospitalizations. Compared with ventricular pacing, atrial-based pacing (physiologic modes) reduced stroke and atrial fibrillation (“AF”). There was a significant reduction in the composite outcome of stroke or cardiovascular mortality, but only among patients with SSS. Results of quality of life, exercise capacity, functional status and pacemaker syndrome are variable. Physiologic modes were associated with higher rates of perioperative complications (lead dislodgement and infections). Results were independant of age, sex, hypertension, left ventricular dysfunction, unpaced heart rate, history of heart failure or AF. Recent pacemakers with specific algorithms for minimal ventricular pacing, as compared to conventional dual-chamber pacemakers, did not reduce mortality or heart failure hospitalizations. It just moderately reduced the risk of persistent AF and the percentage of ventricular pacing. Conclusions: HAS recommands generally implanting a single chamber pacemaker for the management of bradycardia. Dual-chamber pacemakers DDDR have to be reserved for 2 situations: (i) SSS with evidence of impaired atrioventricular conduction, (ii) permanent AVB without AF. HAS will not recommend that pacemakers with specific algorithms for minimal ventricular pacing be systematically used instead of single-chamber pacemakers in patients presenting with SSS or paroxysmal AVB, unless more clinical trials are performed. [Copyright &y& Elsevier]