Jansen C, et al. - In this investigation, researchers validated wireless remote heart rate variability (HRV) surveillance in cirrhosis decompensation and determined whether severely reduced HRV is a surrogate for inflammation and progression of cirrhosis decompensation, as well as evaluated whether HRV measurement determines cirrhosis decompensation prognosis. HRV was monitored for 111 patients (74 male) at two clinical sites at risk of cirrhosis decompensation. Using remote monitoring (Isansys Lifetouch) and/or Holter electrocardiography recording, the standard deviation of all normal beat-beat intervals (SDNN) reflecting HRV was evaluated. During 90-day follow-up, clinical outcomes and major prognostic scores were recorded. Investigators found that remote wireless HRV monitoring identifies patients with cirrhosis at high risk of developing acute-on-chronic liver failure and mortality. This will help guide appropriate early intervention if SDNN drops below a specified threshold and evaluate therapy response with potential economic benefit to health. The data presented support the need for additional controlled remote HRV monitoring studies in patients with cirrhosis at risk of decompensation.