Telemedicine: A promising solution for heart failure ?

Heart failure, despite considerable therapeutic progress, remains a frequent, serious and costly disease, particularly because of the very frequent readmissions. Thanks to major advances in information technology and communication, telemedicine (remote medical practice), appears as a promising solution for the improvement of its care. Since ten years, France approved five telemedicine procedures, including tetemonitoring, which has been extensively studied for heart failure. It enables the detection early signs of cardiac decompensation and thus, through therapeutic adaptation, avoid hospital readmission. The monitoring of multiple physiological parameters, invasive and non-invasive, is currently possible thanks to many tools (structured telephone support, standalone devices, cardiac implantable devices for therapeutic or diagnostic purposes) with continuous innovations (e.g. wearable devices). Although the result of dozens of randomized clinical trials is divergent (due in particular to the complexity of telemonitoring and the heterogeneity of the techniques used), the different meta-analyzes show a medical and economic benefit of remote monitoring. That is why, pending the results of studies in progress, particularly in France, our country has set up for the first time a real-life experience (ETAPES program). Despite the many unanswered questions, telemedicine, combined with advances in artificial intelligence, represents a huge potential for future management of heart failure. (C) 2020 Published by Elsevier Masson SAS on behalf of l'Academie nationale de medecine.