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Implantable heart technology is being used in Manchester to assess when a patient is at high risk of dying, thanks to research led by the University of Manchester and the Manchester University NHS Foundation Trust.
Implantable pacemakers and defibrillators contain several sensors that allow continuous monitoring of a patient’s heart health, 24 hours a day.
The study published in Europace and funded by the Medical Research Council is a collaboration between the University of Manchester, Manchester University NHS Foundation Trust (MFT), Health Innovation Manchester and Medtronic – which manufactures implantable devices.
The research team looked at remotely monitored health data from 439 patients treated at the Manchester Royal Infirmary (MRI), part of the MFT, over a two-year period.
The study reported a threefold increase in the odds of death for patients who spent at least one day in “high risk” status. Risk status is determined by a combination of up to nine factors.
There was also a 26% increase in the chances of death for patients who had 14 or more consecutive days in a high-risk condition – compared to those with shorter high-risk episodes.
Researchers are currently studying whether integrating data from remotely monitored devices into care pathways can reduce hospitalizations and mortality.
Dr Fozia Ahmed, Honorary Reader in Cardiovascular Sciences at the University of Manchester and Consultant Cardiologist at Manchester Heart Center, part of MRI, said: “The remote monitoring capabilities of modern cardiac devices enable continuous monitoring. health-related data in patients’ homes.
“The data can help identify when there is a potentially significant change in a patient’s clinical condition, helping to predict future clinical adverse events, such as hospitalization and death.
“Historically, cardiologists have seen patients at hospital appointments for six to 12 months. If a patient with heart failure does not feel well between appointments, we rely on contact with the patient. But patients don’t always know they are not doing well until it is too late.
“We believe this technology could be a game-changer in the management of heart patients, especially those with heart failure.
“In Greater Manchester, based on the research data, we have started using device-derived alerts, which notify the healthcare team when a patient is detected by the device as’ high risk. », Prompting a telephone consultation with a specialist.
“The whole process, from detecting a high-risk episode to assessment and follow-up, is known as the TriageHF Plus care path – originally developed in Manchester, it is now more widely used. used. “
In recognition of their outstanding contribution to healthcare, TRIAGEHF Plus was highly recommended in the HealthTech Partnership of the Year category, announced in June at the 2021 HSJ Partnership Awards.
Dr Camilla Sammut-Powell, NIHR Applied Research Collaboration Greater Manchester at the University of Manchester and Senior Research Statistician, said: “This is the first prospective study to show that data from implantable electronic devices remotely monitored cardiovascular risk score, can be used to predict mortality.
“This routinely monitored data, collected automatically every day, can help distinguish patients at high and low risk of death.
“Such information can personalize a clinician’s decision making to ensure that the patient is receiving therapies designed to improve their long-term prognosis. “
A spokesperson for Medtronic, the industry collaborators that make the device, said: “The increase in mortality identified in the assessment has justified the need for collaboration between industry and the NHS in this space, to create a digital solution that aims to ensure that high risk notifications are sent directly to cardiac care teams who can take action as clinically indicated, based on data relating to the health of the patient’s device. patient and patient-reported symptoms.
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