Technical innovations that can help you manage heart failure

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By Wai Hong Wilson Tang, MD, as reported to Hallie Levine

While we’ve come a long way in treating and treating heart failure, we still have room for improvement. By 2030, over 8 million adults will be living with heart failure, a 50% increase from almost 2 decades ago. We must do everything we can to give these people what they need to thrive after their diagnosis.

This is where digital health and technology come in. There is good research showing that they can help both doctors and patients manage heart failure and improve life with the disease. Here’s what I think is the most promising.

remote monitoring. While this has been available for a number of years, it’s really been put to use during the COVID-19 pandemic, when many people with heart failure chose to isolate at home to protect themselves. We typically monitor a patient’s heart activity using a Holter monitor, a device that is fitted and fitted in the doctor’s office. This allows us to verify that the 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, a small waterproof patch that attaches to the chest and that providers can ship directly to patients. They wore it for 2 weeks and then sent it back to the company for their heart data to be analyzed.

Implantable Devices. We can now take remote monitoring a step further and implant devices that can track your heart health at home. The CardioMEMS HF system is new. This is a tiny pressure-measuring device that a doctor inserts into your pulmonary artery during surgery. You then use a home electronics unit to take daily pulmonary artery pressure measurements at home, and this data is forwarded to your heart failure medical team for review. A study known as the CHAMPION study found that using this type of implantable device reduced heart failure hospitalizations by 28%. It makes sense: If your doctor can get your pulmonary artery pressure under control, it should prevent your heart failure from getting worse.

Various applications. Both Apple and Fitbit have EKG-like apps that you can use to check your heart rhythm. (An electrocardiogram, or EKG, is a test, usually done in your doctor’s office, that measures your heart’s electrical activity.) You may find an irregular heartbeat or increased heart rate, which can help you diagnose and treat your heart failure. I just recently caught up with a new heart failure patient who told me she was diagnosed after her Apple Watch noticed her heart rate skyrocketing. Luckily, her illness 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 shortness of breath, swelling in her ankles or legs, or fatigue.

Apps can also help you manage the mundane aspects of your life. An app, Health Failure Storylines, developed by the Heart Failure Society of America, allows you to record daily vital signs 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 helpful in finding out how well a drug is working and if it’s causing side effects.

text messages. An important part of heart failure management is making sure you’re taking your medications regularly, eating a healthy diet, and exercising regularly. This is where SMS check-ins from your doctor or treatment center can be helpful. A small study of 60 people with heart failure found that enrollment in a text reminder program along with a remote blood pressure and weight monitoring program reduced their chances of being hospitalized by 50%. Other research shows that text messaging improves medication adherence for all types of diseases, including heart disease.

The bottom line? Studies show that these types of technologies and programs can reduce your chances of being hospitalized or dying of heart failure. But while they are all useful, they cannot replace a personal visit to your doctor. It still requires a careful balancing act between electronic and human contact. When we see patients face to face we can really build a relationship, which we can’t always do over text or the internet. But taken together, they have the potential to truly revolutionize patient care.



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