Heart failure is among the leading causes of hospitalization and exacts a heavy toll in Slovakia and around the world. Half of patients die within five years of diagnosis, and the lifetime risk affects roughly one in four people. A new Slovak telemedicine technology shows that timely and non-invasive monitoring can markedly reduce these risks without overburdening outpatient clinics.
Why monitor heart failure remotely
Heart failure is a condition with major clinical and economic impact. It often leads to repeated hospitalizations and, despite treatment, carries an unfavorable prognosis. This is why professional societies in Europe recommend systematic patient monitoring.
Hospitalization is usually not caused by a sudden event, but by a gradual chain of changes in the body. First, filling pressures in the heart increase, then come fluid retention, shortness of breath, weight gain, edema, and finally decompensation requiring a hospital stay. The key is to detect warning trends days to weeks in advance. That is exactly why the ESC recommends both invasive and non-invasive telemonitoring as a way to prevent hospitalizations.
A non-invasive alternative to measuring filling pressures
So far, the best results have come from invasive measurement of filling pressures using an implanted sensor. Such devices can detect risky trends even 30 days before hospitalization, and their benefit has been confirmed by multiple studies. The drawback, however, is the procedure and the associated burden on the patient.
The new Slovak technology offers a non-invasive approach using a pulse oximeter and a specialized artificial intelligence algorithm. The patient measures at home for two minutes standing and two minutes lying down; from the hemodynamic change with the change in posture, the system estimates filling pressure in the heart. The physician then sees clear graphs and key data points for decision-making. The device is a certified medical device and in Slovakia has been routinely available for more than two years, including reimbursement by insurers.
Real-world experience: fewer hospitalizations, not more work
To avoid increasing administrative burden, patient onboarding is handled directly by the technology provider: they deliver the device, and the technical team explains the measurement procedure. The data are first reviewed by an internal team of physicians and nurses who assess risk situations. Only cases requiring intervention then reach the attending physician.
So far, more than 500 patients have passed through the program and over 100 physicians collaborate; more than 10 000 PPG measurements have been generated. Of approximately 34 000 internal alerts, only about 2 700 were escalated healthcare events, which saves time for outpatient clinics. In a cohort of 300 patients followed for six months, hospitalizations fell by 53 % compared to standard care; on average per 100 patient-months, there were roughly 33 consultations, 13 therapy adjustments, and only 2 additional check-ups. In practice, the system, for example, caught deterioration after discontinuation of a diuretic and later also after a respiratory infection (covid), with treatment adjustments returning the values to normal.
