Thanks to a swathe of medical technology (medtech) advances over the past decade, the doctors treating cardiac patients in 2020 have access to a previously unattainable amount of potentially life-saving data as well as the tools, arming them with the knowledge to make crucial interventions ahead of time.
At Mediclinic City Hospital, cloud-based data analytics have transformed the way doctors means of share information securely and remotely monitor patients.
“We have many patients who are using commercially available devices that can measure, store and share information such as blood pressure, heart rate, oxygen saturations and even electrocardiograms,” says Dr Adam Mather, Consultant Interventional Cardiologist at Mediclinic City Hospital.
We have many patients who are using commercially available devices that can measure, store and share information such as blood pressure, heart rate, oxygen saturations and even electrocardiograms.
He cites the example of Kardia, a small US Food and Drug Administration-approved finger pad that allows patients to accurately record an electrocardiogram, which then syncs with a smartphone.
“The technology enables cloud storage of the data, which can then be shared securely with their physician to aid diagnosis and guide clinical management.”
Tele cardiology
With large number of people staying home to slow the spread of the coronavirus, tele cardiology is a medtech sector that has become increasingly crucial. With cardiovascular disease still the leading cause of death worldwide, according to the World Health Organisation, patients need a way to be monitored and diagnosed and treated that reduces the risk of exposure to the virus.
“Some advantages are that physical distancing can be maintained, patients don’t have to visit hospital or clinics, which increases the risk of exposure to Covid, and their time is saved since no commuting is needed,” explains Dr Amal A. Louis, Consultant – Interventional Cardiologist at Aster Hospital, Mankhool.
Now with improving technology, not only blood pressure and heart rate but even a patient’s weight, any signs of fluid overload in the lungs, ECG, oxygen saturation and kidney function can be monitored through tele cardiology.
He says that tele cardiology was being used even before the pandemic to monitor patients at home – particularly those with heart failure – in a process known as tele monitoring.
“Now with improving technology, not only blood pressure and heart rate but even a patient’s weight, any signs of fluid overload in the lungs, ECG, oxygen saturation and kidney function can be monitored through tele cardiology.”
Big data
At the heart of it all is data analytics, which UAE hospitals are taking advantage of to gain a clearer understanding of their patients’ condition. Dr Sarath Babu Devarakonda, Specialist Interventional Cardiology at Lifecare Hospital, Musaffah, lists some ways data including cloud-based analytics is being used in his department to improve treatment outcomes. “Data analytics is critical for hospital coding; for accuracy in coding; big data is necessary for contact tracing, identifying risk factors and forecasting the need for future services, patient satisfaction scores, universal electronic medical record adoption, care management analytics, which show a full picture of the patient over the long term, and identification of risk-rising patients.”
Data analytics is critical for hospital coding; for accuracy in coding; big data is necessary for contact tracing, identifying risk factors and forecasting the need for future services.
The cath lab at Lifecare Hospital has a number of new technologies employed to monitor patients, including Wi-Fi-enabled pacemakers that allow for remote monitoring, long-term heart rhythm (event)-monitoring devices that last up to two years, and wearable devices that can analyse cardiac rhythms.
Meanwhile, at Mediclinic City Hospital, Dr Mather sees interventional as a dynamic field ripe with emerging new technologies. “In coronary artery intervention we often have to treat arteries blocked with calcium deposits that are resistant to balloon inflations. We have recently adopted a new orbital atherectomy technique to debulk the calcification. This technique is the first major advancement in more than 25 years in the treatment of calcified coronary arteries.”
He also cites the examples of the transcatheter aortic valve, which can be implanted without open-heart surgery, and 3D electro-anatomical navigation systems that can identify targets for radio frequency ablation therapy, which can cure heart rhythm issues that cause palpitations.
Artificial intelligence
Dr Louis is convinced that AI will come to the fore of cardiac intervention in the future. “The technology may be able to advise patients about what to do and inform them when to seek medical attention. In certain medical specialties they may also be able to advice on treatment.”
Home monitoring
With a pandemic motivating people to stay home as much as possible, it’s important that heart patients are able to monitor some aspects of their condition without needing to visit the hospital.
One of the risk factors for people with heart disease is high blood pressure, or hypertension. Recent guidelines from the European Societies of Cardiology and Hypertension recommended home blood pressure monitoring as a valid strategy to confirm the diagnosis of hypertension.
“In view of this, not only hypertensive patients but also the health-conscious who want to stay ahead of future events that might compromise their health would benefit from regular blood pressure check-ups,” says Zeeshan Nasir, Area Trade Marketeer at OMRON Healthcare Middle East.
Not only hypertensive patients but also the health-conscious who want to stay ahead of future events that might compromise their health would benefit from regular blood pressure check-ups.
OMRON’s EVOLV, an all-in-one blood pressure monitoring cuff that wraps itself around the upper arm, was designed to alleviate the burden of BP monitoring at every step, explains Nasir.
“The display, monitor and cuff have been integrated into a compact one-piece device, with no tabletop unit, no tubes, and no wires.”
Also important are the EVOLV’s internal memory, which can store up to 100 readings, and its ability to sync with OMRON’s Connect app, which makes it easy to share readings and trends with physicians.
Dr Amal A. Louis, Consultant – Interventional Cardiologist at Aster Hospital, Mankhool, says there are various devices available for home monitoring – especially heartbeat or rhythm monitoring. “[They] can monitor a patient’s heart rhythm for 24 hours up to several weeks. Some of these are external that patients need to wear while some can be planted underneath the skin close to the heart for recording their heart beat and any variation in heart rhythm. These devices play a major role in diagnosing patients who present with palpitations, dizziness or blackouts where no abnormalities are visible when they visit the doctor and these devices through home monitoring guide us with diagnosis for the patient’s condition.”
