Health services all over the world have been stretched taut as overburdened hospitals and overworked physicians are working round the clock to care for COVID-19 patients. Under these circumstances, regular check-ups have become a challenge for those managing cardiovascular diseases. However, with remote monitoring systems like Cardiovascular Implantable Electronic Devices, patients can stay up-to-date with their disease management, rendering the need for frequent hospital visits moot, tells Ajay Singh Chauhan, General Manager – India, SEA, HK, Taiwan and Korea, Cardiac Rhythm Management, Abbott, to Tarannum Rana
The coronavirus pandemic has rendered routine medical checkups and consultations difficult for patients. Times are especially hard for those with Cardiovascular Implantable Electronic Device (CIED) implantations requiring regular and meticulous monitoring. Under such circumstances, how can remote monitoring be of any assistance in these cases?
The current and unprecedented times have had a major impact on healthcare systems across the globe, including India. There are restrictions in movement due to concerns on health and safety, and even with the lockdown being eased gradually in some parts of the country, the way health is managed is changing. This is where technology like remote monitoring plays a critical role, especially for heart patients with implants, where regular consultations and check-ups are important.
Doctors often recommend implantable cardioverter defibrillators (ICD) and cardiac resynchronisation therapy defibrillator (CRT-D) devices for heart rhythm management of patients with arrhythmia (abnormal heart rhythms). Arrythmia causes the heart to beat in a chaotic manner, and it is unable to pump blood effectively. Remote monitoring in these devices helps streamline communication and increase engagement between doctors and their patients, without physical presence.
Can you share with us some data on the effectiveness of remote monitoring for cardiovascular disease management?
There is strong clinical evidence surrounding remote monitoring that has led to changes in practice management guidelines to include Class 1A recommendations that all patients with CIED should be offered remote monitoring. Nevertheless, only a small percentage of patients with pacemakers are currently being followed remotely. Given that pacemakers are the most widely implanted cardiac device, implementation of remote monitoring for these patients represents a significant, but under-utilised opportunity to improve patient outcomes.
Remote monitoring leads to better patient outcomes and reduced burden on the healthcare system. It also allows for identification of asymptomatic episodes as well as patient-triggered transmissions, which can lead to earlier intervention. For people living with potential arrythmias, an insertable cardiac monitor (ICM) placed just under the skin during a minimally invasive procedure — can continuously monitor for abnormal heart rhythms and detect arrhythmias.
For people living with heart failure, changes in the pressure of blood through their pulmonary artery can indicate a worsening condition — and may be detected before a patient notices any symptoms. Our heart failure system remotely and proactively monitors cardiac activity and sends data to treating physicians – as cardiac activity changes, care plans between in-person meetings can be adjusted.
How does a remote monitoring system for cardiovascular check-ups function?
The implantable cardiac device, which is a minicomputer, communicates directly with technology in the doctor’s office. It works when a transmitter syncs with the pacemaker or ICD, collecting data about the heart’s activity, such as its rate and rhythm, as well as data about the device itself. The transmitter then sends that information by way of a secure website to the hospital for the doctor to interpret. This syncing and transmission can happen overnight, while one sleeps.
Patients can always be in touch with the doctor through tele-consultation. The doctor has the medical history of the patient and can offer the best-suited medical advice, even from a distance.
The Remote Patient Monitoring Device Market is expected to hit a 6.7 per cent CAGR mark by the year 2024. What are some promising trends in this sector that you foresee?
Cardiovascular devices in use today represent years of scientific research that can help provide better care and meaningfully impact patients’ lives. For people with recurrent arrhythmias, medical devices such as pacemakers and implantable cardioverter defibrillators (ICD) can help by continuously monitoring the heart’s electrical system and providing automatic correction when an arrhythmia occurs. Our family of devices is MRI-ready and assists physicians in monitoring patient status and device performance daily with automatic remote monitoring. We also have an insertable cardiac monitor, implanted through a minimally invasive procedure, that delivers necessary information to physicians to help diagnose difficult-to-detect arrhythmias with fewer interruptions to patients’ daily lives.
Recently, we announced the CE mark for our new implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy defibrillator (CRT-D) devices, with the most advanced heart rhythm management capabilities along with a new set of benefits for people with abnormal heart rhythms and heart failure. These devices offer opportunities for patient engagement and remote monitoring through new smartphone connectivity and connected applications. Additional benefits include a patient-preferred design, improved battery longevity and MRI compatibility.
Abbott is listed among the companies which have a strong product portfolio in electrophysiology technology. Tell us about the growth that the company has experienced so far in the electrophysiology devices sector with respect to the Indian market.
Electrophysiology focusses on the electrical activity of the heart and is a specialised science. In India, the process of electrophysiology is gaining importance as it gives a credible diagnosis of abnormal heart rhythms by studying the electrical system of the heart. It also allows treatment options through advanced ablation procedures. We offer a full range of electrophysiology solutions that give physicians the versatility to access and diagnose, as well as manage an array of cardiac arrhythmias.
Arrhythmia management is multi-faceted, requiring solutions that span the patient care continuum – from diagnostics to therapy. Today, a doctor has options to access, diagnose, treat and manage arrhythmias with versatility and effectiveness. Our catheters used by electrophysiologists provide access solutions that make it easier to navigate varied anatomies and reach certain areas of the heart – focussing on manoeuvrability and stability that are designed to improve procedural efficiency and effectiveness.