Innovations
A small wireless patch worn on the chest makes cardiac monitoring more comprehensive and less cumbersome for the patient.
SINCE EARLY LAST YEAR, cardiology patients who present at Weirton (W.Va.) Medical Center with symptoms suggestive of heart rhythm problems have been prescribed a small sensor to track their heart data and help physicians diagnose their condition.
It’s typical for patients who visit a cardiologist after experiencing a stroke or reporting heart palpitations to get prescribed a portable electrocardiogram device to wear at home. Such devices record a patient’s heart rhythm, which cardiologists analyze to diagnose atrial fibrillation and other heart conditions.
But that usually involved short-term ECG devices that patients wear for one or two days, said Dr. John Cherian, a cardiologist at Weirton. To monitor patients longer and in a more comfortable way, Cherian in early 2020 started to try out a new device—a wireless sticker patch that a patient wears on their chest for a week.
“Patients aren’t comfortable having people know that they’re wearing some kind of monitoring device,” Cherian said. A wearable sensor helps with that concern, since patients can easily wear the device under their clothes. The sensor, about the weight of two quarters, replaces traditional Holter monitors.
The sensor continuously records a patient’s heart rhythms for a week; the patient also keeps a journal of their symptoms for the cardiologist to later compare against the ECG data. After a week, the patient returns to the office to remove the sensor and have the data downloaded.
The office runs the patient’s data through the associated ECG analysis software—sold by Cardiac Insight, the same company that makes the wearable sensor—which flags elements like possible atrial fibrillation and compiles the data into a report for doctors to review.
Cherian said his office is prescribing the seven-day wearable sensor to his patients, unless the patient runs into challenges with insurance, which is rare.
Long-term continuous ECG monitoring with the device is covered by Medicare, Medicaid and some private payers, said Brad Harlow, CEO of Cardiac Insight. He said the company charges hospitals for the ECG sensor and software based on their patient volumes, but declined to share the average price.
The cardiac monitoring
market generated $965 million in 2019 across the U.S., Europe and the Asia-Pacific region, according to market research firm Frost & Sullivan, and is expected to reach $1.4 billion by 2023. That’s in part due to growing interest in and reimbursement for wearables in ambulatory ECG monitoring, said Srinath Venkatasubramanian, an industry analyst at the firm.
The market for medical-grade ECG monitoring wearables is expected to reach $618 million by 2023, nearly half of the entire cardiac monitoring market.
“These kinds of patches have made it easier and less cumbersome for patients to wear,” Venkatasubramanian said.
And a sensor that patients wear for a week or more can help to improve diagnoses by capturing more data—particularly useful for patients who don’t experience heart rhythm issues daily.
“You can catch things that otherwise are not going to be detected,” depending on how frequently a patient experiences an issue, said Dr. Luigi Di Biase, a member of the American College of Cardiology’s electrophysiology council.
Di Biase, section head of electrophysiology and director of arrhythmia services at Montefiore Medical Center in New York City, said he wasn’t familiar with the specific sensor from Cardiac Insight, but has prescribed other multiday ECG monitoring patches from companies iRhythm Technologies and BioTelemetry.
Hospitals across the U.S. have begun investigating the potential for wearable devices to improve diagnostics and treatment for cardiac conditions.
Heart attack patients participating in a virtual cardiac rehab program at Kaiser Permanente wear a smartwatch while completing exercises, which helps their care teams monitor activity levels and heart rate. Researchers at Smidt Heart Institute at Cedars-Sinai are trying out ways to monitor patients at high risk for heart attacks and heart failure with various types of wearables.
Cardiology is ripe for experimentation with wearables, in part because care decisions are often informed by measuring specific vital signs like blood pressure, heart rate and ECG data, said Dr. Raj Khandwalla, director of digital therapeutics research at Smidt Heart Institute. That data can help assess how patients are responding to treatment.
“You have clear physiological signals that can be measured … and that can really give us a good picture of how a patient is doing,” Khandwalla said. ●