JMIR Cardio

Heart failure is a prevalent condition ideally managed through collaboration between health care sectors. Telehealth between cardiologists and primary care physicians is a strategy to improve the quality of care for patients with heart failure. Still, the effectiveness of this approach on patient-relevant outcomes needs to be determined.

Atrial fibrillation (AF) is associated with an increased risk of stroke. Oral anticoagulation (OAC) is used for stroke prevention in AF (SPAF), but it also increases bleeding risk. Clinical guidelines do not definitively recommend for or against OAC for patients with borderline stroke risk. Decision-making may benefit from values clarification exercises to communicate risk tradeoffs.

Nonadherence to medication is a key factor contributing to high heart failure (HF) rehospitalization rates. A conversational agent (CA) or chatbot is a technology that can enhance medication adherence by helping patients self-manage their medication routines at home.

Patients with cardiovascular implantable electronic devices (CIEDs) typically attend in-person CIED clinic visits at least annually, in addition to remote monitoring (RM). Because the CIED data available through in-person CIED clinic visits and RM are nearly identical, the 2023 Heart Rhythm Society expert consensus statement introduced “alert-based RM,” an RM-first approach where patients with CIEDs that are consistently and continuously connected to RM, in the absence of recent alerts and other cardiac comorbidities, could attend in-person CIED clinic visits every 24 months or ultimately only as clinically prompted by actionable events identified on RM. However, there is no published information about patient and clinician perspectives about barriers and facilitators to such an RM-first care model.

Clinical guidelines recommend high intensity statin therapy for patients with acute coronary syndrome (ACS). However, high intensity statins have been underused in this population.

The Portfolio Diet is a dietary pattern for cardiovascular disease (CVD) risk reduction with 5 key categories including nuts and seeds; plant protein from specific food sources; viscous fiber sources; plant sterols; and plant-derived monounsaturated fatty acid sources. To enhance implementation of the Portfolio Diet, we developed the PortfolioDiet.app, an automated, web-based, multicomponent, patient-facing health app that was developed with psychological theory.

Heart rate (HR) is a vital physiological parameter, serving as an indicator of homeostasis and a key metric for monitoring training intensity. Wearable devices utilizing photoplethysmography (PPG) technology offer non-invasive HR monitoring in real-life settings, continuous validation of their accuracy and reliability across different activities is essential, as performance may vary due to factors such as wearing position, blood flow, motion or device updates.

The Insertable Cardiac Monitor (ICM) clinical pathway in Tampere Heart Hospital, Finland, did not correspond to the diagnostic needs of the population due to a lack of resources for insertion and follow-up. There has been growing evidence of delegating the insertion from cardiologists to specially trained nurses and outsourcing the remote follow-up. However, it is unclear if the change in the clinical pathway is safe and improves efficiency.

Care4Today is a digital health platform developed by Johnson & Johnson comprising a patient mobile app (Care4Today Connect), a health care provider (HCP) portal, and an educational website. It aims to improve medication adherence; enable self-reporting of health experiences; provide patient education; enhance connection with HCPs; and facilitate data and analytics learning across disease areas, including cardiovascular disease.

Digital technologies are increasingly being implemented in health care to improve the quality and efficiency of care for patients. However, the rapid adoption of health technologies over the last 5 years has failed to adequately consider patient and clinician needs, which results in ineffective implementation. There is also a lack of consideration for the differences between patient and clinician needs, resulting in overgeneralized approaches to the implementation and use of digital health technologies.

Atrial fibrillation (AF) is a prevalent arrhythmia associated with significant morbidity and mortality. Despite advancements in ablation techniques, predicting recurrence of AF remains a challenge, necessitating reliable models to identify patients at risk of relapse. Traditional scoring systems often lack applicability in diverse clinical settings and may not incorporate the latest evidence-based factors influencing AF outcomes. This study aims to develop an explainable artificial intelligence model using Bayesian networks to predict AF relapse post-ablation, leveraging on easily obtainable clinical variables.

Electrocardiography is an essential tool in the arsenal of medical professionals, Traditionally, patients have been required to attend healthcare practitioners in person to have an electrocardiogram (ECG) recorded and interpreted. This may result in paroxysmal arrhythmias being missed, as well as decreased patient convenience, and thus reduced uptake. The advent of wearable ECG devices built-in to consumer smartwatches has allowed unparalleled access to ECG monitoring for patients. Not only are these modern devices more portable than traditional Holter monitors, but with the addition of artificial intelligence (AI)-led rhythm interpretation, diagnostic accuracy is improved greatly when compared to conventional ECG-machine interpretation. The improved wearability may also translate into increased rates of detected arrhythmias. Despite the many positives, wearable ECG technology brings with it its own challenges. Diagnostic accuracy, managing patient expectations and limitations, and incorporating home ECG monitoring into clinical guidelines have all arisen as challenges for the modern clinician. Decentralised monitoring and patient alerts to supposed arrhythmias has the potential to increase patient anxiety and healthcare visitations (and therefore costs). To better obtain meaningful data from these devices, provide optimal patient care and provide meaningful explanations to patients, providers need to understand the basic sciences underpinning these devices, how these relate to the surface ECG and the implications in diagnostic accuracy. This review article examines the underlying physiological principles of electrocardiography, as well as examines how wearable ECGs have changed the clinical landscape today, where their limitations lie, and what clinicians can expect into the future with their increasing use.