Success in heart failure management at Sentara

Managing heart failure has been a challenge for both patients and providers for a long time. The condition often leads to fluid buildup in the lungs, causing shortness of breath, fatigue, disrupted sleep, and frequent trips to the emergency department due to the heart’s inability to pump effectively. A newer approach to monitoring is changing that trajectory, offering patients a way to stay ahead of symptoms before they escalate.

The Heart Failure Management System (HFMS) by Zoll Medical is a wearable external device designed to track subtle changes in pulmonary fluid levels. The patch-like device is worn by patients for up to ninety days and continuously monitors hydration in lung tissue, an early indicator that fluid may be building up.

Traditionally, many heart failure patients don’t realize fluid retention is happening until symptoms become severe. By then, intervention is often reactive instead of preventive. HFMS aims to change that by detecting increases in fluid levels before a patient feels any different.

When the device identifies a consistent upward trend over several days, it sends an alert directly to the patient’s healthcare provider. From there, providers can check in with patients, assess how they’re feeling, review medication adherence, and make adjustments, often increasing diuretics or other medications to bring fluid levels back down.

Chelsea Christensen, a cardiac physician assistant who manages the HFMS program at Sentara Virginia Beach General Hospital, says early detection is key.

“Most of the time when I get an alert and call my patients, they don’t have symptoms yet,” she explained. “We adjust their medication, and by the next day, we often see those levels improve.”

This proactive approach is helping to break a cycle that many heart failure patients know all too well: hospitalization, discharge, and eventual readmission. Fluid retention can be unpredictable, and even patients who adhere to their care plan can experience sudden changes.

Patient compliance also plays a significant role. Many individuals are prescribed diuretics, which can interfere with daily routines due to frequent urination. Others may run out of medication or delay refills, mistakenly believing they no longer need them. In fact, providers have noticed a pattern. Around 35 to 37 days after discharge, fluid levels often rise as prescriptions run out.

HFMS not only helps catch these trends early but also reinforces patient education. By connecting daily habits to measurable outcomes, patients gain a clearer understanding of how medication adherence directly impacts their health.

The device is designed to be simple. Patients apply the adhesive sensor to their left side. Activation and set up are done over the phone with Zoll customer service, the monitor is shipped directly to patients, and data is transmitted automatically. Patients themselves don’t receive alerts; only providers do.

Heart failure is a broad diagnosis, generally categorized into two types: a weakened heart muscle or a stiffened one. HFMS is effective for both and is typically recommended for patients who have recently experienced an exacerbation. Some exclusions apply, such as patients already using advanced implantable monitoring devices or those expected to begin dialysis within ninety days.

Since launching in April 2024, Sentara’s HFMS program has seen more than 300 patients using the device, and expansion is underway. Implementation has already begun at Sentara Princess Anne Hospital, and leaders are working toward system-wide adoption.

Beyond immediate monitoring, HFMS may also help determine which patients could benefit from long-term solutions, such as implantable devices like CardioMEMS.

For many patients, the biggest benefit is simple: staying out of the hospital. “It gave me peace of mind,” said heart failure patient Carolyn Belson. “When I learned the monitor would be looking after me, I said, ‘Sign me up!’”

Heart failure remains one of the most common causes of hospital readmission, but tools like HFMS are offering a new path forward with early detection, daily monitoring, and timely intervention. For patients caught in the cycle of repeat hospital visits, that can make all the difference.