Integrated management of heart failure: clinical and technology Vision of a clinical cardiologist

In patients with heart failure, there are great difficulties in the clinical diagnosis of circulatory congestion, given its late presentation and the frequent dissociation between semiological examination and hemodynamic profiles. There is evidence that therapeutic interventions that seek to descend the left ventricular filling pressures high, guided by implantable hemodynamics sensors have a favorable effect on the quality of life of patients (decreased re hospitalizations), but there is still defined the true impact of these interventions on survival. It has initiated a path of monitoring systems ever more efficient, with active participation from the patient. The combination of multiple diagnostic elements can increase the clinical usefulness of monitoring with devices. The transmission of a great variety of data at central medical by the patient (telemonitoring) may have an additional benefit on current monitoring and control methodologies. The success of integrated management not only unify clinical and technology. We must prepare to interpret, manage and implement these new working methodologies in daily practice.