Heart failure (HF) is a complex and costly disease process associated with high morbidity and mortality. Implanted cardiac rhythm management devices are increasingly used in the HF population to provide therapies such as protection from sudden death and cardiac resynchronization therapy. Device-based diagnostic monitoring provides clinicians with information that can assist in identifying patients at risk for HF decompensation and subsequent hospitalization. This article will review the evidence for using diagnostic information from cardiac rhythm management devices in the management of HF patients. Future advanced monitoring devices will also be discussed.