Implantable heart technology could be “game-changing” for monitoring cardiac patients, especially when they are at high risk of dying, a study has found.
Research led by the University of Manchester and Manchester University NHS Foundation Trust used implantable pacemakers and defibrillators that contain multiple sensors, which enables a patient’s heart to be continuously monitored 24 hours a day.
The study, published in Europace, involved examining data from 439 patients who were being cared for at Manchester Royal Infirmary (MRI) over two years.
The researchers found a three-fold increase in the odds of mortality for patients who spent at least one day in “high-risk” status and a 26% increase in the odds of mortality for patients who had 14 consecutive days or more in a high-risk status, compared with those whose high-risk episodes were shorter.
They are now investigating if integration of the remotely monitored device data into healthcare pathways can reduce hospitalisations and mortality.
Dr Fozia Ahmed, honorary reader in cardiovascular sciences from The University of Manchester and consultant cardiologist at The Manchester Heart Centre, part of the MRI, said: “Remote monitoring capabilities of modern-day cardiac devices enables continuous monitoring of health-related data in the patients’ own homes.
“The data can help identify when there is a potentially significant shift in a patient’s clinical condition, helping to predict future adverse clinical events, such as hospitalisation and death.
“Historically, cardiologists have seen patients at six to 12-month hospital-based appointments. If a patient with heart failure is unwell between appointments, then we rely on the patient getting in touch. But patients don’t always know they are unwell until it is too late.”
“We believe this technology could be a game-changer in the management of cardiac patients, particularly those with heart failure.”
He added that the device-derived alerts are being used, which notify the care team when a patient is detected by the device as ‘high-risk’, prompting a telephone consultation with a specialist.
Lead statistician for the study Dr Camilla Sammut-Powell, from the NIHR Applied Research Collaboration Greater Manchester at The University of Manchester, said: “This is the first prospective study to show that remotely monitored cardiovascular implantable electronic device (CIED) data, summarised as a risk score, can be used to predict mortality.
“This routinely monitored data, automatically collected every day, can help discriminate between patients at high and low risk of death.
“Such information may personalise a clinician’s decision making towards ensuring that the patient is in receipt of therapies designed to improve their long-term prognosis.”
The researchers are undertaking a follow-on study to evaluate the costs and resources of implementing the new heart failure care pathway.
Ahmed FZ, Sammut-Powell C, Shing Kwok C et al. Remote monitoring data from cardiac implantable electronic devices predicts all-cause mortality. Europace 3 October 2021.
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