MedCity Influencers, Devices & Diagnostics

The Future of Heart Health – Continuous Heart Monitoring

When it comes to heart health, time is of the essence. ECGs are considered the most reliable tools, but only if they are continuous and long-term in nature. Continuous Heart Rhythm Monitoring is simply the only solution for prevention and/or management for the number one global health issue.

Heart health issues are intermittent and often asymptomatic, leaving issues undetected with individuals unaware of any underlying problem. This presents itself in places where we least expect them, for example Danish soccer player Christian Eriksen or the most recent occurrence with Damar Hamlin. These are athletes in top performance shape who go through comprehensive physicals regularly, yet things are missed.

Recent improvements in technology have tried to help but they do not go far enough and end up causing more noise. The question is why is this such a difficult problem to solve? Heart issues have been the no. 1 cause of death for years and yet we are still suffering globally with millions of heart attacks and strokes occurring annually. The problem lies in the nature of heart issues: They are intermittent, making them incredibly difficult to capture. The solution is continuous heart monitoring just like continuous glucose monitoring.

The current tool for prevention and diagnosis of cardiovascular disease (CVD) is the Electrocardiogram (ECG). Conducted either in a clinic or hospital or in an ambulatory setting, an ECG measures the electrical activity of the heartbeat. Specifically, it measures two kinds of information:  The length of time it takes a wave to travel from one part of the heart to the next and whether that time is normal, fast, slow, or irregular; as well as measuring whether the heart is too large or overworked based on the electrical activity passing through the heart muscle. Unfortunately, the disease being intermittent makes short duration ECGs unreliable. To accurately determine risk factors, you must approach intermittent disease symptoms with a continuous scanning period over an extended period. This is where ambulatory ECG diagnostics come into play, where users wear a device for 7 days, on average, or longer. This has become the gold standard in cardiac diagnostics, long term continuous ECG monitoring for at-risk patients.

Unfortunately, ECGs and ambulatory diagnostics do not account for individuals that would not seek out a hospital or clinic without a symptom or concern. This is why CVD is called a silent killer, with as many as 50% of all cardiac deaths occurring in individuals with no prior history or symptoms of heart disease. Continuous heart rhythm monitoring (CHRM) is built on the premise that when it comes to CVD, it is no longer a question of who the disease will impact, but what any of us can do, at any stage of our lives, to protect ourselves. It understands that among young athletes, for example, cardiac arrest is the number one killer despite the comprehensive physicals and stress tests they undergo. It understands prevention and diagnosis rely on continuity, ease of implementation and reliability of results.

The only type of monitor proven to accurately record heart data and respond is a chest strap monitor using sensor technology to record heart rhythms. Combined with powerful analytics, these devices continuously track your heart rhythm while simultaneously delivering personalized insights directly to you or your health provider. As noted earlier, success with monitoring depends upon consistency, ease of use, and reliability of results. A chest strap monitor is small and easy to wear. This means keeping it on, even while sleeping, because 1 in 8 people that suffer from CVD die in their sleep. At the first sign of abnormality, or a cardiac event, a CHRM alerts you and/or your connected provider, improving the chances of catching the event in time, or preventing it altogether.

The argument for CHRM technology finds its precedence in the success of Continuous Glucose Monitoring (CGM), a technology that helps people manage types 1 and 2 Diabetes. Prior to CGM, patients evaluated their blood glucose levels through a Glucometer, requiring user intervention for every reading, much like today’s personal ECG or HR devices. But the result of this measurement is information for a single moment in time. Experts realized that it was the continuous fluctuations that caused the most damage. CGM provides continuous monitoring and, most importantly, immediate feedback to prevent those fluctuations.

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While there are a variety of popular wearable pulse tracking or ECG watches that have raised awareness around the benefits of heart rate tracking, these technologies are extremely limited. Recording no more than a couple minutes of ECG, they are like a Glucometer, requiring manual intervention to collect data. As seen in diabetes, there is no comparison between a glucometer and CGM. In the case of CVD, the difference is even starker, as cardiac issues are intermittent and asymptomatic, making CHRM a necessity not a nice-to-have. We must follow the CGM trend in diabetes through CHRM, the only tool capable of supporting management and prevention of CVD.

Cardiovascular disease continues to be the number one cause of death worldwide because of its intermittent nature and the difficulty in diagnosis, but it doesn’t have to be. Long term monitoring can support diagnoses, prevention and management for those at risk or diagnosed with cardiac disease. When it comes to heart health, time is of the essence. ECGs are considered the most reliable tools, but only if they are continuous and long-term in nature. Continuous Heart Rhythm Monitoring is simply the only solution for prevention and/or management for the number one global health issue.

Credit: Narongrit Doungmanee

Dr. Waqaas Al-Siddiq DBA, the founder of Biotricity, is a serial entrepreneur, a former investment advisor, and an expert in wireless communication technology. He has designed digital, analog, embedded, and micro-electro-mechanical products. As CEO of Biotricity, a medical diagnostic and consumer healthcare technology company, he has guided the company through every stage of bringing its biometric remote monitoring solutions to market.

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