Remote management of some implanted devices are changing the way doctors address health conditions like heart disease
Exciting and new applications of remote management in the field of cardiology are allowing doctors to identify, monitor and sometimes treat patients’ conditions in real-time without visiting a clinic in person – a feat that simply wasn’t possible as recent as 20 years ago.
“I always recommend the home monitoring [devices] for my patients,” says Dr. Blandine Mondésert, MD. A cardiologist in Montreal, Que., Mondésert specializes in cardiac electrophysiology and caring for patients with congenital heart conditions.
Remote monitoring devices are wearable or implantable medical devices that can detect and even manage certain health conditions. The devices connect to an app via Bluetooth, allowing patients to monitor their own health on a smartphone or tablet. The devices can also send reports to patients’ medical teams.
When doctors are remotely notified about changes in their patients’ conditions, they can change treatment or schedule followup visits if necessary.
Some devices can also be reprogrammed remotely – something doctors and patients alike have especially appreciated during the COVID-19 pandemic. Based on the device’s reports, doctors can adjust device settings to better monitor or manage a condition, without the patient visiting the clinic.
Mondésert says the devices allow her to get a much clearer picture of a patient’s condition than what she can get from a short appointment.
During the months between appointments, Mondésert doesn’t know anything about what’s going on. However, she explains that “with the Bluetooth-connected devices, we are able to follow patients more closely.”
Mondésert says the devices give her patients peace of mind, knowing they are being monitored in between visits without the need to visit the clinic.
Réjean Duval, 55, is one of Dr. Mondésert’s patients in Montreal. Duval has a Medtronic LINQ II, an insertable cardiac monitor that detects sporadic abnormal heart activity. He was the first person in Canada to receive this monitoring device in January 2021, at the Montreal Heart Institute.
“I find it reassuring to have this device that allows doctors to better follow my condition to best diagnose me,” he says.
Duval has suffered from three cryptogenic strokes – strokes for which the cause is unclear. The first one took place when he was only 26 years old and was entirely unexpected, given his excellent state of health.
It’s challenging to diagnose his case, because many years can pass without episodes. Holter monitors – the go-to diagnostic monitoring tool of choice – are worn externally and cannot be tolerated for long term day-in, day-out use.
Eventually, doctors inferred that his strokes stemmed from an inherited heart vulnerability that caused atrial fibrillation. Atrial fibrillation is a dangerous heart rhythm that can cause blood to pool in the heart. The pooling blood can coagulate, causing blood clots and eventually stroke. Additionally, in patients who have had a cryptogenic stroke, atrial fibrillation is generally asymptomatic and therefore difficult to diagnose.
The doctors suggested the implantable LINQ II Insertable Cardiac Monitor so that they could better follow his condition over the long term. The monitoring device can last for up to 4.5 years once inserted, making it ideal for diagnosing intermittent conditions like Duval’s.
The LINQ II is a modern technological achievement. It’s tiny — only the size of a stick of gum — and the insertion process is minimally invasive, meaning it can be completed same-day in a procedure room.
Additionally, the user’s clinician can securely program the device parameters post-insertion based on new information. Remote reprogramming is helpful for patients who would otherwise have to travel long distances to see their specialist. It’s also helpful during the COVID-19 pandemic, when clinic visits are potentially risky.
Duval has yet to have his device programmed remotely, but is tracking his symptoms using the smartphone app to ensure that his physicians are receiving reports about his condition.
“The app keeps readings of how my heart is doing, and if I have symptoms, I can enter them with a description [so the doctors know what was happening at the time of the event],” he says.
The doctors hope the data from the device will help them to more accurately diagnose and manage Duval’s condition.
Mondésert emphasizes that remote monitoring devices can save lives.
Without home monitoring devices, cardiologists rely on in-clinic appointments, which can only give them a snapshot of the patient’s condition.
“If the patient doesn’t have the home monitoring system, I can only discover [problems like] atrial fibrillation [when they visit the clinic],” she explains.
For patients like Duval, the device provides peace of mind without affecting their daily lives. Some patients might even forget it’s there.
“I have no devices [or wires], everything is under the skin. If you wanted to see it, you would have to feel my skin to know it’s there,” he says.
For cardiologists, the new technology allows them access to real-time data like never before.
While treating heart patients is always complex, the power of remote monitoring devices can provide invaluable diagnostic information for ongoing management of the patients’ conditions.
This story was created by , Postmedia’s commercial content division, on behalf of Medtronic.