Dave Fornell, editor of DAIC Magazine
Movement Toward Simpler, Wearable Cardiac Monitoring at ACC.18
An example of the new generation of inexpensive, wearable cardiac monitors that are seeing increased usage. This is the Cardea Solo device. After the monitoring period is over, the wearable patch is torn open to retrieve a data pod that is inserted into a reader to download the data. The software automatically creates reports based on the data, complete with waveforms for various cardiac measures.
The show floor at the American College of Cardiology (ACC) 2018 meeting included numerous vendors offering small, easy-to-use, inexpensive, leadless wearable cardiac monitors. These are being offered as replacements for bulky, expensive Holter monitors that patients wear on their belt and require wire leads to be attached to several points on their bodies. These new monitors can record long periods of cardiac activity and usually have a button for patients to use when they want to flag an event. They can be worn in the shower and while sleeping and offer many practical advantages over the older standard event monitoring technologies. The devices just stick onto a patient's chest and the outer covering is usually disposable. I have seen these devices gaining ground at both ACC and at the 2017 Heart Rhythm Society (HRS) meetings and predict they will be the monitoring technology of choice in the future.
I spoke with one of these companies, Cardea, which offers the ability for practices to take ownership of their own monitoring services and reports instead of outsourcing it to a third party. I included a segment on how the device works in the VIDEO Editor's Choice of Most Innovative New Cardiac Technology at ACC 2018.
In sessions and one featured research presentation, consumer-grade patient monitoring systems like the Apple Watch were being examined as a way to boost patient engagement and gather long-term data on a patient's cardiac health. One study from Cleveland Clinic showed how a smartwatch could be used to reliably detect atrial fibrillation in patients — ECG on Smartwatch Accurately Detects AFib. It reminded me of one of the key late-breakers from HRS 2017, where Apple Watch heart rate data was used in combination with an artificial intelligence (AI) algorithm to detect atrial fibrillation in patients. That University of California, San Francisco study (Artificial Intelligence Detects AFib Using Apple Watch Heart Rate Sensor) and the new ACC research showed the concept of how consumer devices could be modified to help detect early indicators of cardiac arraythmias long before the owners become symptomatic. It offers food for thought as healthcare looks for new ways to leverage population health data to proactively improve patient outcomes and cut healthcare costs by treating less sick patients.
Key Late-breaking Clinical Trials
I highlighted some of the most interesting late-breaking clinical trials on new technology or new approaches to care presented at ACC in the article Latest Data on Cardiac Technology From ACC.18. It includes key data on greatly improved outcomes of the HeartMate 3 LVAD (left ventricular assist device), wearable defibrillators, six-month dual antiplatelet therapy (DAPT), patent foramen ovale (PFO) closure and a new approach to hypertension patient engagement.
For a complete list of the late-breakers with links to stories and videos, read the article ACC 2018 Late-Breaking Trials.
ACC.18 Video Interviews
Here is the list of the nine videos I shot at ACC. The first link is a tour of some of the most interesting new technologies I found on the expo floor.
VIDEO: Sex Differences in Diagnosing Heart Disease in Women — interview with Doreen DeFaria Yeh, M.D.
VIDEO: TAVR for Degenerated Surgical Valves — Valve-in-Valve TAVR Procedures — interview with Sammy Elmariah, M.D.
VIDEO: iFR Found More Cost Effective Over Standard FFR — interview with Manesh Patel, M.D.
VIDEO: Addressing Adult Congenital Heart Referrals — discussion with Ami Bhatt, M.D.
VIDEO: How to Avoid Acute Kidney Injury in the Cath Lab — discussion with Hitinder Gurm, M.D.
VIDEO: Therapies for Advanced Heart Failure — interview with David Lanfear M.D.
VIDEO: Detection of Vulnerable Plaque and Pre-emptive Stenting — discussion with Ron Waksman, M.D.
VIDEO: Strategies to Avoid Acute Kidney Injury Caused by Cath Lab Contrast — interview with Roxana Mehran, M.D.