Rethinking the future of heart care through the prism of technology

A recent study reported that 80% of COVID-19 patients report post-recovery cardiac complications, so cardiologists will need the latest technology to enhance patient outcomes.
As we battle the pandemic, it becomes much more important to look at how technological innovation is paving the way for improved care quality and better patient outcomes, especially to tackle the burden of CVD in India.

A greater fundamental question on how the future of healthcare will be treated post COVID-19 is at the other end of the pandemic. Reports by doctors protesting the shortage of equipment and non-COVID patients complaining about the lack of treatment have shed light on a more pressing problem that has been facing India’s burden of non-communicable diseases for decades (NCDs).

Via minimum invasion, treating patients
With advanced therapeutic services, technical breakthroughs and monitoring technologies that offer better prognosis and give patients an increased quality of life it is important to see how we are handling the disease burden. Today, we have remote monitoring systems that allow patients to document and evaluate the state of their heart when people have socially distanced themselves and are searching for virtual ways of communicating with their doctors.

For example, for patients with heart arrhythmias that cause the heart to beat too fast, slowly, or out of rhythm, devices are available that detect irregular heartbeats and relay data to the smart phone of the patient using Bluetooth. This data will be further exchanged with the doctor who can gain access to the patient’s heart condition in real time, being anywhere in the world.

Even when devices are available, it remains the greatest challenge for a cardiologist to decide in which cases to use them. When it comes to cardiac treatment, there is no 'One Size Fits All solution. As different patients have different needs, a person with diabetes and another with kidney disease can need distinct types of stents. In certain cases depending on the angiographic outcome alone, patients undergo stenting or surgery.

Technologies such as the Fractional Flow Reserve are a more reliable way of deciding whether a stent is required (FFR). FFR monitors the blood flow rate and the oxygen supply to the distal portion of the blocked artery. The technology offers an evaluation of the magnitude of the lesion in the coronary artery and the supply of blood to the affected areas of the heart. During this procedure, the measurement obtained helps the cardiologist determine the magnitude of a coronary artery lesion and helps evaluate whether or not stenting is necessary.

FFR assists in determining the exact location of the lesion when angiography is not clear. In developed countries such as the UA and Japan, FFR is the first line of evaluation with the highest standard of proof, and it is part of the international ESC guidelines.

Medical breakthroughs for patients of all ages have solutions
Science today also has solutions for elderly patients or patients with a poor heart and a history of lung, kidney, or brain-related non-cardiac disorders. For decades people with a leaky mitral valve had to undergo conventional open-heart surgery or take medication. In a four to six-hour long operation, open heart surgery meant opening the chest, followed by six to eight weeks of strict recovery protocol. With minimally invasive procedures carried out using a catheter and a film, it is now possible to patch a leaking mitral valve without opening the heart. The procedure will bring the time for recovery down to a single day.

For babies, various forms of occluders that can be inserted in the heart to close birth defects such as the patent foramen ovale (PFO) from a minimally invasive catheter procedure are among the many available therapies today.This device closes the opening in the heart, ensuring that blood clots that are the primary cause of strokes are not released. India has witnessed a surge in stroke cases in the last few years. Crediting it to technology, we now have new heart defect treatment methods that aim to outperform the approach conventionally used in stroke units.

Cardiac care is evolving like never before in India. For patients of all ages, we now have a wealth of options. The goal is to provide the best treatment options for different patient requirements without compromising the quality of healthcare. In today’s fight against a pandemic, it is imperative to look at a future that will encourage innovation and always keep patient safety a priority.