Heart diseases in India: Remote monitoring can significantly reduce fatal outcomes of cardiac ailments

Implantable devices can help doctors monitor your heart health remotely. This can significantly bring down cases of sudden death due to cardiac ailments.

According to a series of news studies published in The Lancet, India has been witnessing an alarming increase in the occurrence of heart disease, stroke, diabetes and cancers over the past 25 years. The incidence of CVD's and cardiac ailments has risen over the years due to factors such as smoking, diabetes, hypertension, abdominal obesities, psycho- social stress, unhealthy diet and physical inactivity. One of the most common heart disorders experienced by people is sudden cardiac arrest. It occurs when the heart suddenly stops beating. This is caused due to an irregular heartbeat also known as an arrhythmia. More than 60 per cent of all cardiac deaths happen due to sudden cardiac arrest.

Causes of sudden cardiac arrest and ways to prevent it

Cardiac arrest, also known as sudden cardiac death, is a life-threatening heart condition. It occurs when the heart stops pumping blood around the body. Most of these fatalities are caused due to abnormal heart beats called Arrhythmia. Cardiac arrhythmia or irregular heart rhythm is a cardiac ailment that occurs when the heart starts to beat abnormally fast or abnormally slow. These irregular heartbeats can be categorized into bradycardia and tachycardia, and atrial fibrillation. However, there are causes of sudden cardiac arrest which include coronary artery disease, heart attack, enlarged heart (cardiomyopathy), valvular heart disease, congenital heart disease, electrical problems in the heart. To prevent cardiac arrest, it is important to live a heart-healthy lifestyle to reduce your risk of heart disease. A heart-healthy lifestyle includes:

Eating a healthy diet
Staying physically active and maintaining a healthy weight
Quit smoking
Avoiding caffeine and alcohol
Reducing stress and anger as they can cause heart attacks
Using over-the-counter medications with caution, such as some cold and cough medicines, since they may contain stimulants that can trigger a rapid heartbeat (arrhythmia)

Role of devices like ICD and CRT-D in cardiac treatment

An implantable cardioverter-defibrillator (ICD) is a small battery-powered device placed in your chest to monitor your heart rhythm and detect irregular heartbeats. It delivers electric shocks via wires connected to the heart to fix abnormalities in the heart rhythm. ICDs detect and stop abnormal heartbeats (arrhythmias). The device is specialized to continuously monitor heartbeat and deliver electrical pulses to restore the heart rhythm whenever necessary. A CRT-D device is a special device for heart failure patients with a high risk for sudden cardiac death. A CTR-D device delivers small electrical impulses to the left and right ventricles to help them contract at the same time. This helps the heart pump more efficiently.

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With technology evolving at a fast pace, ICDs are also adapting to it. The new ICDs are a minicomputer or Bluetooth device that is implanted under the skin of the upper chest area and is small enough to fit in the palm of your hand. It can monitor the heart constantly and deliver therapy in the form of a shock, when it senses an abnormal heart rhythm. While they help in maintaining heart rhythm, they also store information that the doctor can use to program the ICD for the best possible therapy for cardiac ailments.

How does an ICD work?

ICD or Implantable Cardioverter-Defibrillators are used to prevent patients from dying due to a heart attack. Once the device is implanted, it detects heart rhythm through flexible insulated wires called leads. These wires are placed inside of the heart muscle and attached to the device. Leads transmit the heart rate information to the ICD. When any abnormality occurs, the ICD sends an electric shock to the heart muscle to defibrillate it. ICDs can also provide lower or higher energy therapy to treat rhythm disorders and monitor other cardiac ailments.

Role of remote monitoring app in the functioning of devices like ICD

A secure remote monitoring app is an effective and accurate tool for monitoring the heart health of patients with disease conditions such as arrhythmias or abnormal heartbeats and heart failure. It can be used by patients who have undergone a device implantation. The remote monitoring technology makes it possible for information to be transmitted from the patient's ICD directly to the doctor. This helps the doctor in reviewing the patient's heart activity and detect abnormalities, if any. The process involves the syncing of the transmitter with the pacemaker for collecting data on the heart's rate and rhythm. The device transmits the information through a secured website to the doctor. This syncing and transmission can happen 24X7 even while one is asleep and enables the doctor who has the medical history of the patient to offer the best medical advice, remotely.

Post the outbreak of COVID-19, patients have been avoiding hospital visits and medical consultations due to concerns on health and safety. During these times, tele-consultation is being widely used by patients for seeking medical intervention for cardiac ailments. Monitoring the heart rhythm, a crucial role in treating and managing arrhythmias. Cardiac arrhythmia patients who have undergone device implantations such as pacemakers especially require constant monitoring both from the doctor and patient's end. It is in such situations that technologies like remote monitoring enable heart patients with implants to monitor their heart rhythm within the comfort of their homes. Remote monitoring also makes it possible for the patient to transfer medical information about their condition to the doctor without meeting them in-person.

Benefits of ICD and CRT-D devices

ICD: Devices such as ICDs are designed to treat abnormally fast heart rates. They continuously monitor the patient's heart and restores the heart to its normal heart rate. Doctors often recommend ICDs for prevention of sudden cardiac death in patients who suffer from reduced cardiac function and who may be at risk of suffering from life-threatening abnormal heart rhythms.

CRT-D: Devices such as CRT-Ds are also useful to improve the function of the heart that prevent sudden death similar to traditional ICDs, but in addition act to restore the heart's natural pattern of beating in patients with reduced cardiac function and progressive heart failure despite optimal medical therapy.

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