By Wai Hong Wilson Tang, MD, told to Hallie Levine
While we have come a long way in treating and managing heart failure, there is still more that can be done. By 2030, more than 8 million adults will be living with heart failure, a 50% increase from almost 20 years earlier. We must do all we can to give these people what they need to thrive after their diagnosis.
This is where health and digital technologies come in. Good research now shows that they can help both doctors and patients manage heart failure and improve lives with the disease. Here is what I think is the most promising.
Remote monitoring. Although it has been available now for several years, it was really used during the COVID-19 pandemic, when many people with heart failure chose to self-isolate at home for protection. Normally, we monitor a patient’s heart activity with a Holter monitor, a device that is applied and installed in the doctor’s office. This allows us to verify that the person’s treatment plan is working. But it became more difficult to do during the pandemic. Instead, we often turned to a device known as the Zio patch, a small water-resistant patch that is attached to the chest, which vendors could ship directly to patients. They put it on for 2 weeks and then returned it to the company so their heart data could be analyzed.
Implantable devices. We can now take remote monitoring a step further and implant devices that can track your heart health at home. A new one is the CardioMEMS HF system. It’s a tiny pressure-sensing gadget that a doctor puts into your pulmonary artery during surgery. You then use a home electronic unit to take daily pulmonary artery pressure readings at home, and that data is passed to your heart failure medical team for review. A study known as the CHAMPION trial found that using this type of implantable device reduced hospitalizations for heart failure by 28%. It makes sense: If your doctor is able to control your pulmonary artery pressure, it should prevent your heart failure from getting worse.
Various applications. Apple and Fitbit both have ECG-type apps that you can use to check your heart rate. (An EKG, or EKG, is a test typically done in your doctor’s office that measures the electrical activity of your heart.) They can detect an irregular heartbeat or increased heart rate, which can help you diagnose and to treat your heart failure. . The other day I met a new heart failure patient who told me she was diagnosed after her Apple Watch noticed her heart rate skyrocketing. Fortunately, her illness was caught in the early stages. But without it, she might not have been diagnosed until much later, as she had no other symptoms of heart failure, such as shortness of breath, swelling in her ankles or legs, or exhaustion.
Apps can also help you manage the day-to-day aspects of your life. One app, Health Failure Storylines, developed by the Heart Failure Society of America, allows you to record daily vital data such as weight, blood pressure, and heart rate, as well as medications, physical activity, and even your mood. It also has a symptom tracker, which can be useful in determining how well a drug is working and if it is causing side effects.
Text messages. An important part of managing heart failure is making sure that you take your medications regularly, eat a healthy diet, and exercise regularly. This is where SMS recordings from your doctor or treatment center can come in handy. A small study of 60 people with heart failure found that signing them up for an SMS reminder program, as well as a remote blood pressure and weight monitoring program, made them 50% less likely to end up hospitalized. Other research shows that text messages improve treatment adherence in all kinds of illnesses, including heart disease.
The bottom line? Studies show that these types of technologies and programs can reduce your chances of being admitted to hospital or dying from heart failure. But while they are all helpful, they cannot replace that in-person visit with your doctor. There is always the need for a careful balance between electronic and human contact. When we see patients face to face, we are able to truly establish a relationship, which we cannot always do over text or over the internet. But used together, they have the potential to truly revolutionize patient care.