Vasco trial is a no profit, multicenter, international, prospective, randomized study designed to evaluate the clinical benefits of a remote monitoring management based on ILR vs standard practice in patients with high risk of cardiac arrhythmias, heart failure and left ventricle ejection fraction (LVEF)> 40% .The study will enroll about 331 patients (221 in the ILR group and 110 in the in-hospital follow-up group).

Inclusion Criteria:

• Patients with heart failure, LVEF> 40% who report episodes of palpitations.
• Over 18 years of age
• Ability to provide informed consent for registry participation and be willing and able to comply with the protocol described evaluations

Exclusion Criteria:

• Subject who is, or is expected to be unavailable for follow-up
• Pregnancy
• Medical contraindications for ILR implantation
• Patients with PMK / ICD or with Indication for ICD / PMK implantation
• Cardiovascular events / myocardial revascularization in the previous three months
• Patients already on oral anticoagulant treatment
• Patients who do not want to use the telemonitoring system
• Presence of other recognized indications to ILR (Unexplained syncope, cryptogenic stroke/TIA, Transient loss of consciousness and recurrent falls)