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4.5. Invasive Evaluation
COR LOE
Recommendations
2a B-NR 1. In patients with HF, endomyocardial biopsy may be useful
when a specific diagnosis is suspected that would influence
therapy.
2a C-EO 2. In selected patients with HF with persistent or worsening
symptoms, signs, diagnostic parameters, and in whom
hemodynamics are uncertain, invasive hemodynamic
monitoring can be useful to guide management.
3: No
Benefit
B-R 3. In patients with HF, routine use of invasive hemodynamic
monitoring is not recommended.
3: Harm C-LD 4. For patients undergoing routine evaluation of HF,
endomyocardial biopsy should not be performed because of
the risk of complications.
4.6. Wearables and Remote Monitoring
(Including Telemonitoring and Device Monitoring)
COR LOE
Recommendations
2b B-R 1. In selected adult patients with NYHA class III HF and
history of a HF hospitalization in the past year or elevated
natriuretic peptide levels, on maximally tolerated stable
doses of GDMT with optimal device therapy, the usefulness
of wireless monitoring of PA pressure by an implanted
hemodynamic monitor to reduce the risk of subsequent HF
hospitalizations is uncertain.
Value Statement:
Uncertain Value
(B-NR)
2. In patients with NYHA class III HF with a HF
hospitalization within the previous year, wireless monitoring
of the PA pressure by an implanted hemodynamic monitor
provides uncertain value.
