In conversation with Dr Niti Chadha, Electrophysiologist and Cardiologist, Metro Heart Institute, Faridabad

1. What is the current burden of CVDs in India and what are the causes behind it?

- According to the Lancet Journal, cardiovascular diseases (CVDs) are the number one cause of fatalities globally, taking an estimated 17.9 million lives each year. In 2016, India reported 63% of total deaths due to Non-Communicable Diseases, of which 27% were attributed to CVDs. Most cardiovascular diseases are caused by lifestyle factors such as an unhealthy diet, physical inactivity, and consumption of tobacco and alcohol. The risk factors can lead to high blood pressure, blood glucose, blood lipids, and obesity, thereby increasing the chances of a heart disease.

2. What kind of benefits are offered by heart monitoring technologies like remote monitoring and how is it relevant in the current times where digital health has taken centre-stage in lieu of the COVID-19 pandemic?

- Remote monitoring is a technology for monitoring the heart rate and rhythm of patients suffering from heart conditions such as abnormal heart rhythms and heart failure. Such patients often undergo device implantation like ICD (implantable cardioverter defibrillator) or CRT-D (cardiac resynchronization therapy defibrillator) for managing their condition. Remote monitoring involves syncing of a transmitter with the implanted device for collecting data on the heart’s rate and rhythm. The transmitter then transfers this information through a secured website and server to the doctor. This helps the doctor who has the medical history of the patient to offer best medical advice, remotely. The newer generation devices use a technology that has inbuilt capability to send the device data to the patient’s smartphone via Bluetooth and the phone then automatically transfers the data to the doctor enabling advanced remote monitoring capability. With this the patient does not need to carry the transmitter while traveling and is always connected through his device and smartphone with the doctor. This technology has been a boon to the patients especially in situations like the current pandemic, where in-person consultations come with certain challenges.

3. How does remote monitoring assist the arrhythmia patients?

- Remote monitoring enables patients suffering from cardiac arrythmias and heart failure to play an active role in monitoring their own heart health. It provides doctors the benefit to manage their patients while reducing the time taken to detect abnormalities, as early reaction can help improve patient outcomes. For patients, it provides them with the comfort, flexibility, and security of communicating critical information about their medical condition directly to the doctor at any time of the day, without seeing them in-person. It also helps in precise and accurate diagnosis of arrythmias, while in heart failure patients, the technology helps to keep heart health in check without visiting the hospital. Remote monitoring of implantable devices especially offered to patients who have heart failure, has resulted in improved morbidity of their disease as well as a reduction in the mortality of patients with heart failure.

4. What kind of patients can avail of this technology?

- Any heart patient who has undergone a device implantation can avail the remote monitoring technology for keeping a check on their heart health 24X7.

5. What is the role of healthcare technology in strengthening the doctor-patient connect?

- For the patient, remote monitoring allows them to be more informed, involved and alert about their heart health with an added line of consultation. For the doctors, they can manage their patients, allowing for identification of asymptomatic episodes as well as patient-triggered transmissions, which can lead to earlier intervention and reduced clinical burden. It also provides them with necessary data with clinical validation for ensuring more efficient management of their patients’ condition. Most importantly, it allows people to connect to their physicians anytime, and from anywhere.