Skip to main content

Advertisement

Log in

A sneak peek into digital innovations and wearable sensors for cardiac monitoring

  • Review Paper
  • Published:
Journal of Clinical Monitoring and Computing Aims and scope Submit manuscript

Abstract

Many mobile phone or tablet applications have been designed to control cardiovascular risk factors (obesity, smoking, sedentary lifestyle, diabetes and hypertension) or to optimize treatment adherence. Some have been shown to be useful but the long-term benefits remain to be demonstrated. Digital stethoscopes make easier the interpretation of abnormal heart sounds, and the development of pocket-sized echo machines may quickly and significantly expand the use of ultrasounds. Daily home monitoring of pulmonary artery pressures with wireless implantable sensors has been shown to be associated with a significant decrease in hospital readmissions for heart failure. There are more and more non-invasive, wireless, and wearable sensors designed to monitor heart rate, heart rate variability, respiratory rate, arterial oxygen saturation, and thoracic fluid content. They have the potential to change the way we monitor and treat patients with cardiovascular diseases in the hospital and beyond. Some may have the ability to improve quality of care, decrease the number of medical visits and hospitalization, and ultimately health care costs. Validation and outcome studies are needed to clarify, among the growing number of digital innovations and wearable sensors, which tools have real clinical value.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Steinhubl SR, Topol EJ. Moving from digitalization to digitization in cardiovascular care. Why is it important, and what could it mean for patients and providers? J Am Coll Cardiol. 2015;66:1489–96.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Burke LE, Ma J, Azar KML, et al. Current science on consumer use of mobile health for cardiovascular disease prevention. Circulation. 2015;132:1157–213.

    Article  PubMed  Google Scholar 

  3. Chow CK, Redfern J, Hillis GS, et al. Effect of lifestyle-focused text messaging on risk factor modification in patients with coronary heart disease. A randomized clinical trial. JAMA. 2015;314:1255–63.

    Article  CAS  PubMed  Google Scholar 

  4. Stephens J, Allen J. Mobile phone interventions to increase physical activiy and reduce weight: a systematic review. J Cardiovasc Nurs. 2013;28:320–9.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Uhlig K, Pqtel K, Ip S, et al. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. Ann Intern Med. 2013;159:185–94.

    Article  PubMed  Google Scholar 

  6. Liang X, Wang Q, Yang X, et al. Effect of mobile phone intervention for diabetes on glycaemic control: a meta-analysis. Diabet Med. 2011;28:455–63.

    Article  CAS  PubMed  Google Scholar 

  7. Fanning J, Mullen SP, McAuley E. Increasing physical activity with mobile devices: a meta-analysis. J Med Internet Res. 2012;14:e161.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Whittaker R, McRobbie H, Bullen C, et al. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2012;11:CD006611.

    PubMed  Google Scholar 

  9. Hamine S, Gerth-Guyette E, Faulx D, et al. Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review. J Med Internet Res. 2015;17:e52.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Thakkar J, Kurup R, Laba TL, et al. Mobile telephone text messaging for medication adherence in chronic disease: a meta-analysis. JAMA Intern Med. 2016;176:340–9.

    Article  PubMed  Google Scholar 

  11. Widmer RJ, Collins NM, Collins CS, et al. Digital health interventions for the prevention of cardiovascular disease: a systematic review and meta-analysis. Mayo Clin Proc. 2015;90:469–80.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Urrea B, Misra S, Plante TB, et al. Mobile health initiatives to improve outcomes in primary prevention of cardiovascular disease. Curr Treat Options Cardio Med. 2015;17:59.

    Article  Google Scholar 

  13. Eapen ZB, Peterson ED. Can mobile health applications facilitate meaningful behavior change? Time for answers. JAMA. 2015;314:1236–7.

    Article  CAS  PubMed  Google Scholar 

  14. Liebo MJ, Israel RL, Lillie EO, et al. Is pocket mobile echocardiography the next generation stethoscope? A cross-sectional comparison of rapidly acquired images with standard transthoracic echocardiography. Ann Intern Med. 2011;155:33–8.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kahn HA, Wineinger NE, Uddin PQ, et al. Can hospital rounds with pocket ultrasound by cardiologists reduce standard echocardiography? Am J Med. 2014;127:669.

    Article  Google Scholar 

  16. Biais M, Carrié C, Delaunay F, et al. Evaluation of a new pocket echoscopic device for focused cardiac ultrasonography in an emergency setting. Crit Care. 2012;16:R82.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Vieillard-Baron A, Slama M, Mayo P, et al. A pilot study on safety and clinical utility of a single-use 72-hour indwelling transesophageal echocardiography probe. Intensive Care Med. 2013;39:629–35.

    Article  PubMed  Google Scholar 

  18. Cioccari L, Baur HR, Berger D, et al. Hemodynamic assessment of critically ill patients using a miniaturized transesophageal echocardiography probe. Crit Care. 2013;27(17):R121.

    Article  Google Scholar 

  19. Wagner C, Fredi J, Bick J, et al. Monitoring myocardial recovery during induced hypothermia with a disposable monoplane TEE probe. Resuscitation. 2011;82:355–7.

    Article  PubMed  Google Scholar 

  20. Ritzema J, Troughton R, Melton I, et al. Physician-directed patient self-management of left atrial pressure in advanced chronic heart failure. Circulation. 2010;121:1086–95.

    Article  PubMed  Google Scholar 

  21. Abraham WT, Adamson PB, Bourge RC, et al. Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomized controlled trial. Lancet. 2011;377:658–66.

    Article  PubMed  Google Scholar 

  22. Abraham WT, Stevenson LW, Bourge RC, et al. Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial. Lancet. 2016;387:353–61.

    Article  Google Scholar 

  23. Walsh JA, Topol EJ, Steinhubl SR. Novel wireless devices for cardiac monitoring. Circulation. 2014;130:573–81.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Appelboom G, Camacho E, Abraham ME, et al. Smart wearable body sensors for patient self-assessment and monitoring. Arch Public Health. 2014;72:28.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Michard F. Hemodynamic monitoring in the era of digital health. Ann Intensive Care. 2016;6:15.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Barrett PM, Komatireddy R, Haaser S, et al. Comparison of 24-hour Holter monitoring with 14-day novel adhesive patch electrocardiographic monitoring. Am J Med. 2014;127:95.

    Article  PubMed  Google Scholar 

  27. Tarakji KG, Wazni OM, Callahan T, et al. Using a novel Wireless system for monitoring patients after the atrial fibrillation ablation procedure: the iTransmit study. Heart Rhythm. 2015;12:554–9.

    Article  PubMed  Google Scholar 

  28. Garabelli P, Stavrakis S, Albert M, et al. Comparison of QT interval readings in normal sinus rhythm between a smartphone heart monitor and a 12-lead ECG for healthy volunteers and inpatients receiving sotalol or dofetilide. J Cardiovasc Electrophysiol 2016; epub ahead of print.

  29. Muhlestein JB, Le V, Albert D, et al. Smartphone ECG for evaluation of STEMI: results of the ST LEUIS pilot study. J Electrocardiol. 2015;48:249–59.

    Article  PubMed  Google Scholar 

  30. Kim SH, Lilot M, Sidhu KS, et al. Accuracy and precision of continuous noninvasive arterial pressure monitoring compared with invasive arterial pressure. Anesthesiology. 2014;120:1080–97.

    Article  PubMed  Google Scholar 

  31. Vos JJ, Poterman M, Mooyaart EAQ, et al. Comparison of continuous non-invasive finger arterial pressure monitoring with conventional intermittent automated arm arterial pressure measurement in patients under general anaesthesia. Br J Anaesth. 2014;113:67–74.

    Article  CAS  PubMed  Google Scholar 

  32. Sola J, Proenca M, Chetelat O. Wearable PWV technologies to measure blood pressure: eliminating brachial cuffs. Conf Proc IEEE Eng Med Biol Soc. 2013;2013:4098–101.

    CAS  PubMed  Google Scholar 

  33. Schwartz G, Tee BCK, Mei J, et al. Flexible polymer transistors with high pressure sensitivity for application in electronic skin and health monitoring. Nat Commun. 2013;4:1859.

    Article  PubMed  Google Scholar 

  34. Dagdeviren C, Su Y, Joe P, et al. Conformable amplified lead zirconate titanate sensors with enhanced piezoelectric response for cutaneous pressure monitoring. Nat Commun. 2014;5:4496.

    Article  CAS  PubMed  Google Scholar 

  35. Tomlinson LA, Wilkinson IB. Does it matter where we measure blood pressure? Br J Clin Pharmacol. 2012;74:241–5.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Sun JX, Reisner AT, Saeed M, et al. The cardiac output from blood pressure algorithms trial. Crit Care Med. 2009;37:72–80.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Venture investments in digital health surpasses medical devices. http://www.mddionline.com/article/venture-investment-digital-health-surpasses-medical-devices-141006.

  38. Plante TB, Urrea B, MacFarlane ZT, et al. Validation of the instant blood pressure smartphone App. JAMA Intern Med 2016; Epub ahead of print.

  39. Smith C. Scouting for approval: lessons on medical device regulation in an era of crowdfunding from Scanadu’s “scout”. Food Drug Law J. 2015;70:209–35.

    PubMed  Google Scholar 

  40. Terry NP. Mobile health. Assessing the barriers. Chest. 2015;147:1429–34.

    Article  PubMed  Google Scholar 

  41. Bartels K, Karhausen J, Clambey ET, et al. Perioperative organ injury. Anesthesiology. 2013;119:1474–89.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Pearse RM, Moreno RP, Bauer P, et al. Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012;380:1059–65.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Ghaferi AA, Birkmeyer JD, Dimick JB. Variation in hospital mortality associated with inpatient surgery. N Engl J Med. 2009;361:1368–75.

    Article  CAS  PubMed  Google Scholar 

  44. Abenstein JP, Narr BJ. An ounce of prevention may equate to a pound of cure. Can early detection and intervention prevent adverse events? Anesthesiology. 2010;112:272–3.

    Article  PubMed  Google Scholar 

  45. Taenzer AH, Pyke JB, McGrath SP, et al. Impact of pulse oximetry surveillance on rescue events and intensive acre unit transfers. A before-and-after concurrence study. Anesthesiology. 2010;112:282–7.

    Article  PubMed  Google Scholar 

  46. Bellomo R, Ackerman M, Bailey M, et al. A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards. Crit Care Med. 2012;40:2349–61.

    Article  PubMed  Google Scholar 

  47. Brown H, Terrence J, Vasquez P, et al. Continuous monitoring in an inpatient medical-surgical unit: a controlled clinical trial. Am J Med. 2014;127:226–32.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Frederic Michard.

Ethics declarations

Conflict of interest

Dr. Michard has no conflict of interest to declare in relation with the present publication. He has been a consultant for Pulsion Medical Systems, Dixtal, Hamilton Medical and UPMED, and an employee (VP, Global Medical Strategy) of Edwards Lifesciences. He is the founder and managing director of MiCo Sàrl, a consulting firm providing services to medtech companies and digital health startups.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Michard, F. A sneak peek into digital innovations and wearable sensors for cardiac monitoring. J Clin Monit Comput 31, 253–259 (2017). https://doi.org/10.1007/s10877-016-9925-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10877-016-9925-6

Keywords

Navigation