Smart Technology – a Future Field in Acute Cardiac Care

Abstract

The concept of mobile Health (mHealth) refers to the use of diagnostic devices which can provide information from a remote distance, via internet pathways, that can influence the therapeutic management in a variety of disorders.Several electronic tools have been tested and proven useful in simplifying the cardiovascular management of patients, more specifically mobile applications that are compatible with the Android system, which have led to a 25.5% improvement in quality of primary medical care, patient prognosis, as well as better efficacy of measures for secondary cardiovascular prevention. 1 Such applications include remote monitoring devices for evaluation of cardiac rhythms via iECG, which uses a smartphone (iPhone) with incorporated monitoring electrodes for telemetric cardiac rhythm recordings. Furthermore, such devices include blood pressure measurement tools, which have the configuration of a smartwatch or bracelet that uses the applanation tonometry technique. 2 For heart failure patients, mHealth applications include a remote monitoring device that records the filling pressures within the left ventricle and the pulmonary artery, which is based on a micro-electromechanical system that is implanted at the level of the pulmonary artery. 3 Technological advancements have led to the development of a remote cardiac ultrasound system composed of a transducer connected to a smart mobile phone, which has the capacity to store and transfer the acquired imaging data towards a specialized center for further analysis and interpretation within a clinical context. 4 Telemedicine applications for telephone transmission of ECG recordings from underserved regions have led to a drastic decrease in myocardial infarction-related mortality from 16.4% to 4.8% in 30 days, thus introducing, for the first time, the concept of iICU (internet-based intensive care unit). 5 Electronic devices applied in cardiac care can be used in every phase of patient management, both in acute and long-term care settings, including mobile health in cardiac arrest, rhythm disturbances, acute myocardial infarction, or heart failure. Out-of-hospital cardiac arrest (OHCA) is related to high mortality rates, and timely initiation of correct resuscitation maneuvers could be life -saving. 6 Mobile life-saver is a smartphone application that can identify and alert volunteers that have been trained in cardio-pulmonary resuscitation, and which led to a faster time from OHCA to chest compression. 7 In acute myocardial infarction, it is well known that a decreased time from onset of symptoms to interventional treatment is associated with a significant improvement in survival, as well as short-and long-term complications. 8 However, although in case of activation of a STEMI network by a non-cardiologist specialist reduces times to treatment, it may also increase the rate of false positive activation of such networks. 9 The use of transtelephonic ECG interpretation by a remote cardiology specialist has been shown to reduce STEMI network times, to improve pr...