The shift to preventive cardiac care through remote monitoring of heart failure

Marking the first anniversary of the National Institute for Health and Care Excellence (NICE)’s final diagnostic guidance recommending two technologies for the remote monitoring of heart failure, Helen Quinn from Hospital Healthcare Europe speaks to Boston Scientific’s Duong Tu about the evolving landscape of heart failure management and preventative cardiac care, how the HeartLogic™ algorithm fits into this, and what the recommendation has meant for clinicians, patients and the NHS over the past year.  

 

By predicting heart failure events before they happen, the algorithms provide clinicians with the data they need to enable proactive intervention, improving patient outcomes and increasing the efficiency of healthcare systems.

What’s more, it is estimated that 25,000 people in England have a cardiac device that is compatible with heart algorithm technology, offering further cost-saving implications.³

Managing heart failure patients through remote monitoring

Monitoring heart failure remotely through advanced diagnostics has been steadily growing over the last 15 years, but its adoption – somewhat unsurprisingly – accelerated during the Covid-19 pandemic, notes Duong Tu, Boston Scientific’s Director Sales and Marketing, Cardiac Rhythm Management and Diagnostics, and RhythmCARE in Europe, Middle East and Africa (EMEA).

HeartLogic measures heart sounds, thoracic impedance, respiration and heart rate via a CIED implanted in the patient. This activity is combined into a single composite index by a specially developed algorithm that indicates decompensation. The data is securely transmitted to the clinician daily using secure communication channels. If pre-set data thresholds are met, an alert is sent to the patient’s clinical team allowing proactive intervention to take place.

European trials conducted ahead of the NICE recommendation showed that HeartLogic can reduce heart-failure hospitalisations by 72%.⁴ The technology enables more patients to stay home while their clinical teams receive monitoring information from a distance to help inform clinical decisions and act earlier, saving money on hospital admissions and reducing the length of hospital stays.

‘It’s a multi-parametric algorithm, and it can diagnose in advance a potential heart failure event that could lead to hospitalisation of a patient up to 34 days before,’ Duong says.

NICE identified HeartLogic as the most accurate and consistent of the heart-failure algorithms reviewed in the UK market. Notably, multicentre trials produced reliable, repeatable results across multiple countries, each operating within different healthcare systems and clinical workflows.

‘In the NHS, there’s a great attention right now on prevention and efficiency, but also digitally-enabled care, and I think HeartLogic is hitting on all three of them. It’s very well aligned with what is known as the triple aim of digital health,’ Duong adds, referring to the goals of improving patient experience, population health outcomes and value for health systems.

Improving efficiencies and reducing the burden

Indeed, digital health solutions can help healthcare systems do ‘more with less,’ Duong says. HeartLogic not only alerts clinical staff to the problem, but it also gives insights on heart failure-related paramaters.

“We designed HeartLogic to go beyond simple alerts by providing actionable insights to reduce burden and improve efficiency,” he explains.

The technology also improves coordination between different specialist teams by providing a shared data source that streamlines collaboration. ‘It’s about bringing together different areas of expertise to complement each other and make our solution truly impactful’ Duong says.

Building on this principle, Boston Scientific launched the RhythmCARE service hub more than three years ago — a dedicated solution designed to foster a collaborative, knowledge-sharing approach between clinical staff and Boston Scientific experts. “Having a common data source can help coordinate efforts,” Duong adds. The RhythmCARE service hub offers real-time support for healthcare professionals and patients in 14 languages across multiple regions. “By providing 24/7 remote support, clinicians can access our experts instantly when they have questions without waiting for an in-person visit,” Duong says. “That removes a burden that would otherwise fall on hospitals.”

Acceptance of digital technology

Throughout Europe, public healthcare systems are under increasing pressure, particularly due to aging populations. For heart failure patients, NICE’s recommendation on the use of advanced diagnostics for remote monitoring offers a step towards more efficient ways to manage chronic conditions.

‘I think the NICE recommendation helped a lot in the adoption of the technology, not only within the UK but also internationally’ Duong says.

But it is not just the clinical uptake that has been important, as Tu notes a growing acceptance among patients as well. ‘Today, patients are increasingly open to virtual care, reflecting a growing comfort with alternatives to traditional face-to-face visits’ he explains.

This is, in part, due to the fact that this system allows patients to be looked after 24/7, which takes pressure off both patients and carers, who may face barriers to getting to hospital.

‘This system ensures patients are seen early, enabling timely intervention and preventing conditions from progressing to a more severe stage’ he says.

The data provided by the algorithm not only delivers alerts and clinical support for healthcare teams but also plays a key role in patient education and awareness. It enables clinicians to offer personalised guidance on lifestyle changes, helping patients reduce their risk of worsening heart disease and promoting long-term heart health.

‘By educating and empowering patients, we can make an impact on long-term health outcomes and encourage patient-driven changes,’ Duong adds.

Data accumulation and preventive medicine

As with any digital tool, a key challenge lies in managing the vast amounts of information collected. There’s a need to turn it into actionable insights for clinical teams, rather than simply generating more data.

Duong and his colleagues are focused on reducing the burden of vast datasets and finding the most effective ways to harness the data to advance clinical knowledge and improve patient care.

‘When we look at how society is evolving, we are all constantly monitored by wearables,’ Duong says. ‘How can we use and manage the large amount of data we have to better serve clinicians and their patients? That’s one of the many questions that drive our commitment to advancing science.’

The current landscape of cardiac remote-monitoring technology is rapidly evolving, driven by increasingly rich data and accelerated advances in artificial intelligence (AI). Duong suggests that the data could push healthcare toward a genuinely preventive model, rather than one centred solely on treatment. He hopes these insights help clinicians and their patients anticipate and prevent heart-failure events before they occur.

‘Moving into more preventive care is important. It’s one of the biggest challenges that, as healthcare partners, we have in front of us to make the system sustainable,’ says Duong. ‘These technologies, coupled with AI, show real potential to reshape the way we deliver care.’