Cardiology: digital solutions support those coping with chronic illness

According to the World Health Organization (WHO), cardiovascular diseases are the leading cause of death worldwide, taking an estimated 17.9 million lives each year. Acute events such as heart attacks and strokes stand out in this setting. Chronic heart diseases can also be a debilitating condition for many patients. If cardiology uses digital methods and tools, it can reach more affected people.

Successful management of chronic conditions always includes regular appointments with the family doctor or cardiologist, who checks the structure and function of the heart using diagnostic imaging and an electrocardiogram (ECG). But that is not always an option for people in low and middle-income countries that lack a comprehensive system of health care. According to the WHO, two-thirds of global deaths related to cardiovascular diseases disproportionally affect these very countries. Yet even high-income countries have regions with a poor infrastructure, making regular office visits more difficult, while a lack of access to transportation keeps patients away from care facilities.

These patients can look to eHealth and mHealth for help. Both practices enable patients to collect their own health data, share it with their doctor via a secure connection and use video chat or phone to talk with the specialist about their care. Patients only have to make a physical visit in rare cases. Here’s the catch: cardiology data is more complex than blood sugar levels and blood pressure that many patients routinely measure at home.

You need an ECG test to diagnose cardiac arrhythmias, for example, as cardiac rhythm disturbances can prompt blood to pool in the heart and cause clots to form, which can travel to the brain, where they can cause a stroke. But if arrhythmias are detected, they can be effectively treated to prevent clots from forming.

Today, patients must wear a 24-hour ECG monitoring device that measures and records the heart’s activity. This is quite uncomfortable and restrictive. Ever-evolving smartphone technology and the CE-marked and FDA approved FibriCheck smartphone app can help in this case. The latter uses the camera of a smartphone and is based on photoplethysmography, which measures the volumetric change of the heart by measuring light transmission. The FibriCheck app illuminates the fingertip with the flash of the smartphone camera and measures light absorption over time: light absorption varies with every heartbeat as each beat pumps blood through the body and the subcutaneous capillaries of the fingertip. When they increase in thickness with a heartbeat, they absorb more light, while less light is absorbed between heartbeats. The app measures this fluctuation consecutively for 60 seconds and can suggest a disturbed heart rhythm.

FibriCheck and other cardiology apps are great tools that support patients, especially when they are combined with wearables to enable discreet and continuous heart monitoring. FibriCheck is now also compatible with any Fitbit device. That being said, self-tracking by patients is prone to more errors compared to measurements taken by trained professionals.

Digital helpers augment, support and complement existing exam methods and techniques in medical practices and hospitals. The Frankfurt startup Cardisio developed a unique, AI-based screening method for coronary heart disease. The CardiosioGraph uses electrodes to record electric currents that pass in the patient's chest, providing information about heart muscle activity. Based on the collected data, an algorithm generates a 3D model of the heart to evaluate blood flow and detect potential narrowing in the coronary vessels. The method is non-invasive and easy to use and offers a more effective alternative to traditional procedures. This makes it the jumping-off point for advanced diagnostics and suitable for screening tests.

Alongside new screening methods, apps and wearables are paving the way for cardiovascular care breakthroughs in the future. FibriCheck and Cardisio are just two examples of how young companies can support cardiology and prompt the sector to embrace digitization. They encourage patients to play an active role in chronic disease management, ease the burden on doctors and staff and ultimately cut healthcare costs and save money.

Yet the possibilities go far beyond big health care savings, because these tools can improve cardiology care wherever there is a lack of access to doctor’s offices or hospitals, as long as there is reliable (mobile) connectivity and a power supply. In doing so, they lead to better care, especially where cardiovascular disease places a heavy burden on low and middle-income countries.