Top Things to Know: Advancing Wearable Biosensors for Congenital Heart Disease: Patient and Clinician Perspectives
Published: March 28, 2024
Prepared by Barbara Entl, MD
- This science advisory investigates the current use of wearables in congenital heart disease (CHD) and explores ways to improve these technologies for clinicians and patients alike. Additionally, it addresses ethical and regulatory concerns surrounding the application of wearables, highlighting the need to overcome these challenges to maximize their effectiveness within this demographic.
- Wearable biosensors, or "wearables," are crucial in congenital heart disease, spanning both consumer/wellness and medical-grade devices. These devices, encompassing photoplethysmography (PPG), electrocardiogram (EKG), and accelerometry sensors, enable continuous, extended monitoring of vital health metrics such as arrhythmias, oxygen saturation, physical activity, and heart rate.
- Through continuous physiological monitoring, wearables might detect early changes in patient status. This access to personal health data could empower patients and parents, enabling them to proactively manage their well-being in the face of congenital heart disease.
- Wearable biosensors may offer significant clinical potential in remotely monitoring high-risk infants with shunt-dependent single ventricle physiology, particularly in interstage home monitoring, benefiting this population.
- Despite remarkable technological progress, challenges persist in tailoring wearables for this population, hindering optimal utilization in managing congenital heart disease. These issues encompass hardware design, data interpretation, and seamless integration into clinical protocols.
- One notable challenge arises from the extreme physiological readings commonly seen in CHD patients, such as fluctuating oxygen saturation, heart rate variations, and unique EKG patterns. Biosensors primarily designed for adults often undergo testing based on "normal" ranges, potentially overlooking crucial variations seen in infants with complete mixing or low oxygen levels or supraventricular tachycardia, with heart rates up to 240 bpm. To accurately capture these extreme values, hardware design adaptations must become essential.
- The seamless integration of wearable data into Electronic Health Records (EHR) is critical for informed decision-making and ensuring accessible information for specialists managing patients with congenital heart disease.
- An additional challenge lies in creating platforms equipped to incorporate this data seamlessly and provide alerts signaling the accuracy of wearable device readings to clinicians. This challenge necessitates the development of systems that integrate information and ensure the reliability and interpretation of data from wearable devices.
- Challenges also remain in ensuring privacy. As wearables become more common in healthcare, ethical concerns arise regarding collecting data from populations unable to consent due to age or developmental stage, requiring renewed scrutiny alongside contemporary technology issues like cybersecurity.
- In conclusion, advancing wearable biosensors for CHD necessitates addressing technical, ethical, and regulatory hurdles. Enhancements in hardware design, integration into clinical workflows, and ethical considerations are imperative to fully harness the potential of wearables in managing congenital heart disease while safeguarding patient privacy and promoting informed decision-making among healthcare providers.
Citation
Tandon A, Avari Silva JN, Bhatt AB, Drummond CK, Hill AC, Paluch AE, Waits S, Zablah JE, Harris KC; on behalf of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young (Young Hearts); Council on Lifestyle and Cardiometabolic Health; Council on Clinical Cardiology; and Council on Cardiovascular and Stroke Nursing. Advancing wearable biosensors for congenital heart disease: patient and clinician perspectives: ascience advisory from the American Heart Association. Circulation. Published online March 28, 2024. doi: 10.1161/CIR.0000000000001225