High-tech devices can help track your advanced heart failure symptoms so you feel better, stay out of the hospital, and maybe even live longer.
"Heart failure is not a terminal illness; it's a chronic disease. If you take your medications, follow your health care professional's advice, and stay proactive about managing your disease, you can live for years and have a good quality of life," says Michael M. Givertz, MD, medical director of heart transplant and mechanical circulatory support at Brigham and Women's Hospital in Boston.
Small devices placed in your heart and its arteries can keep track of how well your heart pumps as well as pressure and fluid levels, he says. "The implant wirelessly sends information to your nurse or physician assistant, and they'll decide if you need a change in your therapy" to improve your treatment.
How They Help
Implant monitors are good for people who are more likely to need hospital care for heart failure. "These might be sicker people with moderate symptoms but who want to be proactive about their care. People can slide into worsening heart failure over just days or weeks without realizing it. The idea is to prevent hospital visits and improve your long-term outcome."
Tiny heart monitors can spot signs that your heart failure is getting worse weeks before you'd need to go to the hospital, says Christopher O'Connor, MD, professor of cardiology at Duke University.
"These devices can track multiple variables, so you can see if your heart measurements are abnormal," he says. High-tech advances have improved all heart failure monitors so they're easier to use. "Even if you have a pacemaker, and it needs a battery charge, you can now do this remotely."
Givertz led a trial of CardioMEMS, a new pulmonary artery pressure (PAP) monitor for advanced heart failure. It's a tiny metal loop implanted in an artery inside your heart.
Each morning, you lie on a smart pillow that collects information from a chip in your PAP. The pillow sends wireless messages to your doctor's office about your heart. The trial showed that the PAP lowers your chances of hospital visits and death.
"We found that we could monitor patients more closely and directly, and measure pressure inside their hearts and lungs," Givertz says. "This information lets us see if we need to change anything," such as your medications or how much salt is in your diet.
Left atrial pressure (LAP) monitors are other kind of heart implant. They track blood pressure inside your heart and arteries, specifically targeting the left ventricle, an area that's important in heart failure.
LAPs send daily wireless messages to your doctor so they can change your treatment if something's off. Like PAPs, LAPs also help people with advanced heart failure improve symptoms like low blood pressure, because they give your doctor information about how to adjust the dose of your heart drugs.
Pacemakers and Defibrillators
These types of devices also monitor your heart around the clock. The basic idea is that the implants sense changes to your heartbeat speed and rhythm and, if there's a problem, make changes to save your life. Pacemakers can adjust how quickly your heart beats. A defibrillator sends a slight shock that resets your heart's rhythm.
"Newer pacemakers can also send information about your heart through a device by your bed to your doctor or clinic, so they're becoming more user-friendly," says Adam Burdorf, DO, a cardiologist at University of Nebraska Medicine in Omaha.
Implanted monitors "can sense changes in pressure in your artery before you even feel symptoms," he says. "If you have a problem, it sends an alert directly to your electronic health record at the clinic, which then sends a discreet message to me. It's totally automated."
He can change the dosage of drugs or set up an office visit weeks before a heart problem sends someone to the hospital. "That's so much better for patients with heart failure."
Smart Clothing, Watches, and Apps
Devices or patches that you slap on, clip on, strap to your wrist, carry in your pocket, or wear inside your clothes can also monitor your heart's function, heartbeat strength and rate, or your breathing, weight, and daily steps.
"Wearable devices and smartphone heart monitors are very exciting for people with heart failure. These sensors indirectly measure your heart's pumping and electrical activity," O'Connor says. These are general signs that could let you know when your advanced heart failure is getting worse. "If we can detect heart problems earlier, we can intervene with a change in your medication, a change in diet, or a clinic visit."
Smartwatches and phone apps give you and your doctor more information about your heart health, but they won't replace implanted monitors yet.
"Wearable devices are cool, but the value of this information has not been validated yet in trials," Burdorf says, and there's no proof that wearable sensors will keep you out of the hospital. "Information from one device isn't enough to make good decisions, but having all of this information together is helpful. As technology gets better, the accuracy of these devices could improve a lot."
In the Future
As technology moves forward, heart failure monitors will only improve, O'Connor says. He believes advances like machine learning -- when computers take in and analyze huge amounts of data -- are exciting. For example, scientists are trying to develop a personalized pacemaker that uses machine learning to process data and adapt to your heart after it's implanted.
The challenge, as he sees it, will be how to use all the data smart devices deliver. Each doctor's office will have hundreds of patients who each have several heart monitors.
"We need to integrate all of these technologies. We need to use all of this information about your heart and develop it into something you can use on your own at home," he says. "It's a fun time right now, because things are changing quickly as more engineers get involved in medicine."