Wearables and Implantables: A Time and a Place for Both

With the rising phenomenon of wearables, it is amazing to consider the amount of health information the average consumer now has at their fingertips.

 These devices produce a robust amount of data, providing a glimpse into what’s happening with our bodies in real time – steps taken, calories burned and even heartbeats per minute. It’s no surprise these devices have taken off in terms of popularity as people now have numerous ways to quantify their progress in living a healthy lifestyle on an ongoing basis.

Wearable devices like fitness trackers and smartwatches, which have historically been used during exercise, are now playing a role in monitoring and potentially identifying significant health conditions, such as irregular heart rhythms or arrhythmias. While knowledge is indeed power, as a medical professional, this emerging trend makes me think about the importance of educating patients about the benefits and limitations of these devices and the optimal path to a clinical diagnosis.

Consider atrial fibrillation, a common condition and the most prevalent arrhythmia affecting 33.5 million people globally. Many consumers aren’t aware that atrial fibrillation can lead to and be associated with various heart-related complications, such as blood clots, stroke and heart failure. Symptoms like irregular heartbeats can be unpredictable, infrequent and difficult to detect in some cases. However, today’s technology allows for wearable devices to constantly capture the user’s heartbeat. People are becoming more aware of their heart rhythm – and some are alarmed when they see irregular patterns starting to emerge.

To that point, data presented at the American College of Cardiology Scientific Sessions meeting earlier this year found that while false positive detections from wearables are still a concern, more than half of the patients who received an alert about a potential irregular heartbeat subsequently made an appointment to see a doctor. This is a positive trend; it’s important for a patient who experiences a potential irregular heartbeat to share this information with their physician, who can then determine if more clinical testing is needed. With a condition like atrial fibrillation, it’s critical to identify and treat the condition as early as possible. However, on the flip side, a false alert may alarm someone without a prior history of heart disease and potentially lead to unnecessary and expensive testing.

While a wearable may alert an individual to a possible heart problem, a physician is likely to prescribe a more long-term implantable continuous remote monitor, like an Insertable Cardiac Monitor (ICM), to further evaluate, diagnose, assess symptoms and confirm the presence of an arrhythmia after reviewing the recordings from a wearable device. That is because many physicians will want additional, continuous and accurate arrhythmia monitoring before moving forward with a diagnosis and treatment planning.

For example, the Abbott Confirm Rx ICM device and accompanying smartphone app are designed to help physicians quickly identify even the most difficult-to-detect heart rhythm abnormalities, including atrial fibrillation. The system works remotely and without the need for any patient involvement, unless a patient wants to manually record a cardiac event, often when symptoms are present. The device, which is around the size of a paperclip, is implanted beneath the skin via a minimally invasive, outpatient procedure. It provides patients with an accurate and simple way to continuously monitor for abnormal heart rhythms and record when symptoms occur, with the added comfort of knowing their physician can monitor their heart rhythm remotely. For physicians, this helps manage patients more effectively while enhancing patient compliance through smartphone connectivity and a simple, intuitive app designed for use with the implanted device.

In modern medicine, there’s a time and place for both consumer wearables and medical-grade devices, including implantables. The use of wearables can help increase patient awareness and engagement, which has the potential to improve patient care, while implantables can truly help healthcare professionals make timely, informed and accurate diagnoses.

We're excited for the future potential of implantables, and what we’ll be able to do with technology like Confirm Rx. For example, we may be able to use data produced by an implantable not only to diagnose specific conditions but also to become part of a fully integrated healthcare solution. At Abbott, we are researching how technology may one day help monitor psychological states that impact blood pressure, heart rates, insulin levels and asthma – and correlate sensations and symptoms with biological data. Hopefully, with a more complete view of a patient’s condition (using data generated by both wearables and implantables), we will be able to help them live their best possible life.



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