By Wai Hong Wilson Tang, MD, as told to Haley Levine
While we’ve come a long way in treating and managing heart failure, we can still do better. By 2030, more than 8 million adults will be living with heart failure, a 50% increase compared to nearly two decades ago. We need to do everything we can to give these people what they need to thrive after diagnosis.
This is where digital health and technologies come into play. There is good research now to show that it can help both doctors and patients manage heart failure and improve life with the condition. Here’s what I think is the most promising.
Remote monitoring. While this has now been available for the past several years, it really came into use during the COVID-19 pandemic, when many people with heart failure chose to isolate at home to protect themselves. Normally, we monitor the patient’s heart activity with a Holter monitor, which is a device that is placed and installed in the doctor’s office. This allows us to check that a person’s treatment plan is working. But that became more difficult during the pandemic. Instead, we’ve often turned to a device known as a Zio patch, which is a small waterproof patch attached to the chest, which providers can ship directly to patients. They put him in for two weeks, then brought him back 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. This is a pressure-sensitive instrument that the doctor inserts into the pulmonary artery during surgery. You can then use a home electronic unit to take daily pulmonary artery pressure readings at home, and that data goes to the heart failure medical team for review. One study known as the CHAMPION trial found that the use of these types of implantable devices reduced the incidence of heart failure in the hospital by 28%. It makes sense: If your doctor can control pulmonary artery pressure, that should prevent heart failure from worsening.
Miscellaneous applications. Apple and Fitbit both have ECG-like apps that you can use to check your heart’s rhythm. (An electrocardiogram, or ECG, is a test usually done in your doctor’s office to measure the electrical activity of your heart.) They can pick up an irregular heartbeat, or increased heart rate, which can help you diagnose and treat heart failure. . Just days ago, I met a new patient with heart failure who told me that she was diagnosed with the condition after her Apple Watch noticed her heart rate skyrocketing. Fortunately, her disease was caught in the early stages. But without her, she might not have been diagnosed until much later because she had no other symptoms of heart failure such as feeling short of breath, swollen ankles or legs, or fatigue.
Apps can also help you manage everyday aspects of your life. One app, Health Failure Storylines, developed by the American Heart Failure Association, lets you log daily vitals like 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 helpful in knowing how well a medication is working, as well as if it is causing any side effects.
text messages. An important part of managing heart failure is making sure you take your medications regularly, eat a healthy diet, and exercise regularly. This is where text check-ins from your doctor or treatment center can come in handy. One small study of 60 people with heart failure found that enrolling them in a text reminder program, along with a remote blood pressure and weight monitoring program, made them 50% less likely to be hospitalized. Other research shows that texting improves medication adherence in all kinds of diseases, including heart disease.
The bottom line? Studies show that these types of technologies and programs can lower your chances of being hospitalized or dying from heart failure. But while they are all helpful, they cannot replace that in-person visit with your doctor. A delicate balance between electronic communication and humans still needs to be struck. When we see patients face to face, we can really build rapport, which is something we can’t always do over a text or online. But when used together, they have the potential to truly revolutionize patient care.
Discussion about this post