The challenge, of course, is that most patients with HF spend a small fraction of their lives in the clinic, in front of either HF practitioners or electrophysiology (EP) specialists.  Patients spend the vast majority of the time living their lives at home, well outside the vision and reach of providers, making most days of HF management largely blind, with heavy reliance on patients to self-report symptoms of clinical deterioration.

Unfortunately, patients frequently underreport symptoms because they make unconscious adjustments to their day-to-day life to accommodate subtle changes in effort tolerance or they fail to report changes with sufficient lead time to implement changes in therapy to prevent hosptialization.