Heart failure affects over 64 million people each year across the globe. Around half of those diagnosed with heart failure will die within five years of the diagnosis.
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Heart failure is a considerable burden on worldwide healthcare services; in the UK, for example, the condition requires 1 million bed days per year and accounts for 5% of all hospital admissions.
Although the incidence of heart failure has stabilized over recent years, its prevalence continues to rise due to the aging population alongside improvements to the treatment of ischaemic heart disease and the availability of effective therapies for heart failure.
One of the challenges in managing and reducing heart failure is that it often goes undiagnosed until the person needs to be admitted to the emergency room.
When people think of heart failure, they often picture the acute representation of a heart attack. However, heart failure can develop over time because of conditions such as coronary heart disease or permanently high blood pressure. Therefore, symptoms can go unnoticed for a long time.
In the majority of cases, people with heart failure are not diagnosed until after they are admitted to the hospital in an emergency, even though they likely would have visited their GP previously with heart failure symptoms. The condition, therefore, is difficult to spot, and it is important that innovative methods are established to help recognize heart failure earlier on.
Now, scientists in the UK have pioneered a novel procedure that may improve the early detection of heart failure.
Tiny Sensor Detects Heart Failure Early
In February 2023, a patient in the UK became the first in the world to be fitted with a revolutionary sensor that raises the alarm to the early signs of heart failure. The sensor, which is the size of a pen lid, was inserted into the patient during a simple 45-minute procedure that is part of an international research study that aims to collect evidence that the sensor (FIRE1 System) is effective at monitoring and alerting heart failure in those vulnerable.
The procedure was pioneered by consultant cardiologists Dr. Andrew Flett and Dr. Peter Cowburn at the University Hospital Southhampton (UHS), Hampshire.
During the operation to implant the sensor, it is first collapsed so that it can enter via the body’s largest vein, the inferior vena cava, which is located in the abdomen where it carries oxygen-depleted blood back to the heart.
Once in position, the sensor is then expanded to its original size, ready to continuously monitor the size of the IVC - which correlates to the amount of fluid in the body. Increased amounts of fluid can signal worsening health failure. Elevated fluid levels can relate to fluid build-up in the lungs, which can increase the risk of breathing difficulties and increase the risk of an emergency hospital admission.
Once the sensor is implanted, the patient wears a detection belt over the stomach for as little as 1-2 minutes daily to power the sensor using radiofrequency energy. Data from the sensor is then sent to the heart failure team at UHS each day so that healthcare professionals can pick up and act on warning signs before the patient’s condition worsens.
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Improving Outcomes for Heart Failure Patients in a Post-Pandemic World
The novel device can potentially improve outcomes for patients at risk of heart failure. The sensor may provide the greatest benefit to patients with chronic heart failure, who must be monitored for signs of worsening symptoms. The study will provide evidence of the efficacy of the heart failure sensor, and if successful, the device has the potential to be used worldwide. The impact of this could be improved patient outcomes and reduction of the significant burden of heart failure on healthcare systems.
The SARS-CoV-2 (COVID-19) pandemic pushed many healthcare systems to the brink. Many struggled to keep up with the sudden demand for beds, which led to many non-critical appointments being pushed back. Additionally, patients deemed vulnerable to the effects of COVID-19 were encouraged to remain at home. Unfortunately, being in ill health generally puts a person at a greater risk of falling ill from an infection. Therefore, people who were sick were not seeing healthcare professionals in good time.
To overcome this huge challenge, healthcare saw a drastic shift to telemedicine, where patients can be diagnosed, monitored, and even receive treatment from healthcare professionals who are not physically with them. As COVID-19 infections and restrictions began to ease, healthcare systems continued to leverage telemedicine methods alongside traditional appointments. The novel sensor system currently under investigation fits into this hybrid world, allowing patients to be monitored remotely and alerting healthcare professionals when interventions may be required.
References and Further Reading
First UK patient fitted with heart failure sensor the size of a pen lid [Online]. Sky news. Available at: https://news.sky.com/story/first-uk-patient-fitted-with-heart-failure-sensor-the-size-of-a-pen-lid-12809118
Mohebali, D. and Kittleson, M.M. (2021) “Remote monitoring in heart failure: Current and emerging technologies in the context of the pandemic,” Heart, 107(5), pp. 366–372. https://doi.org/10.1136/heartjnl-2020-318062
Savarese, G. et al. (2022) “Global burden of heart failure: A comprehensive and updated review of Epidemiology,” Cardiovascular Research, 118(17), pp. 3272–3287. https://doi.org/10.1093/cvr/cvac013
Siobhan Chan. 2019. Rushed to hospital: when heart failure isn't diagnosed early enough [Online]. The British Heart Foundation. Available aT: https://www.bhf.org.uk/for-professionals/healthcare-professionals/blog/2019/rushed-to-hospital-when-heart-failure-isnt-diagnosed-early-enough
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