%0 Journal Article %@ 2561-1011 %I JMIR Publications %V 9 %N %P e62719 %T Wearable Electrocardiogram Technology: Help or Hindrance to the Modern Doctor? %A Smith,Samuel %A Maisrikrod,Shalisa %K mobile applications %K electrocardiogram %K wearable monitoring %K app %K wearable %K electrocardiograph %K ECG %K electrocardiography %K mobile app %K tool %K ischemic %K arrhythmia %K wearable ECG %K doctor %K smartwatch %K atrial fibrillation %D 2025 %7 10.2.2025 %9 %J JMIR Cardio %G English %X Electrocardiography is an essential tool in the arsenal of medical professionals, Traditionally, patients have been required to meet health care 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 into 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 with 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. Decentralized monitoring and patient alerts to supposed arrhythmias have the potential to increase patient anxiety and health care 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 in the future with their increasing use. %R 10.2196/62719 %U https://cardio.jmir.org/2025/1/e62719 %U https://doi.org/10.2196/62719 %0 Journal Article %@ 2561-1011 %I JMIR Publications %V 8 %N %P e47730 %T Targeting Key Risk Factors for Cardiovascular Disease in At-Risk Individuals: Developing a Digital, Personalized, and Real-Time Intervention to Facilitate Smoking Cessation and Physical Activity %A Versluis,Anke %A Penfornis,Kristell M %A van der Burg,Sven A %A Scheltinga,Bouke L %A van Vliet,Milon H M %A Albers,Nele %A Meijer,Eline %+ Department of Public Health and Primary Care, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, Netherlands, 31 712568433, E.Meijer@lumc.nl %K smoking %K physical activity %K virtual coach %K eHealth %K development %K collaboration %K conversational agent %K risk factor %K cardiovascular disease %K CVD %K digital %K smoking cessation %K intervention %D 2024 %7 20.12.2024 %9 Viewpoint %J JMIR Cardio %G English %X Health care is under pressure due to an aging population with an increasing prevalence of chronic diseases, including cardiovascular disease. Smoking and physical inactivity are 2 key preventable risk factors for cardiovascular disease. Yet, as with most health behaviors, they are difficult to change. In the interdisciplinary Perfect Fit project, scientists from different fields join forces to develop an evidence-based virtual coach (VC) that supports smokers in quitting smoking and increasing their physical activity. In this Viewpoint paper, intervention content, design, and implementation, as well as lessons learned, are presented to support other research groups working on similar projects. A total of 6 different approaches were used and combined to support the development of the Perfect Fit VC. The approaches used are (1) literature reviews, (2) empirical studies, (3) collaboration with end users, (4) content and technical development sprints, (5) interdisciplinary collaboration, and (6) iterative proof-of-concept implementation. The Perfect Fit intervention integrates evidence-based behavior change techniques with new techniques focused on identity change, big data science, sensor technology, and personalized real-time coaching. Intervention content of the virtual coaching matches the individual needs of the end users. Lessons learned include ways to optimally implement and tailor interactions with the VC (eg, clearly explain why the user is asked for input and tailor the timing and frequency of the intervention components). Concerning the development process, lessons learned include strategies for effective interdisciplinary collaboration and technical development (eg, finding a good balance between end users’ wishes and legal possibilities). The Perfect Fit development process was collaborative, iterative, and challenging at times. Our experiences and lessons learned can inspire and benefit others. Advanced, evidence-based digital interventions, such as Perfect Fit, can contribute to a healthy society while alleviating health care burden. %M 39705698 %R 10.2196/47730 %U https://cardio.jmir.org/2024/1/e47730 %U https://doi.org/10.2196/47730 %U http://www.ncbi.nlm.nih.gov/pubmed/39705698 %0 Journal Article %@ 2561-1011 %I JMIR Publications %V 6 %N 2 %P e37437 %T Digital Health Solutions to Reduce the Burden of Atherosclerotic Cardiovascular Disease Proposed by the CARRIER Consortium %A Scheenstra,Bart %A Bruninx,Anke %A van Daalen,Florian %A Stahl,Nina %A Latuapon,Elizabeth %A Imkamp,Maike %A Ippel,Lianne %A Duijsings-Mahangi,Sulaika %A Smits,Djura %A Townend,David %A Bermejo,Inigo %A Dekker,Andre %A Hochstenbach,Laura %A Spreeuwenberg,Marieke %A Maessen,Jos %A van 't Hof,Arnoud %A Kietselaer,Bas %+ Department of Cardiothoracic Surgery, Maastricht University Medical Center+, P Debyelaan 25, Maastricht, 6229 HX, Netherlands, 31 0652592248, bart.scheenstra@mumc.nl %K atherosclerotic cardiovascular disease %K ASCVD %K cardiovascular risk management %K CVRM %K eHealth %K digital Health %K personalized e-coach %K big data %K clinical prediction models %K federated data infrastructure %D 2022 %7 17.10.2022 %9 Viewpoint %J JMIR Cardio %G English %X Digital health is a promising tool to support people with an elevated risk for atherosclerotic cardiovascular disease (ASCVD) and patients with an established disease to improve cardiovascular outcomes. Many digital health initiatives have been developed and employed. However, barriers to their large-scale implementation have remained. This paper focuses on these barriers and presents solutions as proposed by the Dutch CARRIER (ie, Coronary ARtery disease: Risk estimations and Interventions for prevention and EaRly detection) consortium. We will focus in 4 sections on the following: (1) the development process of an eHealth solution that will include design thinking and cocreation with relevant stakeholders; (2) the modeling approach for two clinical prediction models (CPMs) to identify people at risk of developing ASCVD and to guide interventions; (3) description of a federated data infrastructure to train the CPMs and to provide the eHealth solution with relevant data; and (4) discussion of an ethical and legal framework for responsible data handling in health care. The Dutch CARRIER consortium consists of a collaboration between experts in the fields of eHealth development, ASCVD, public health, big data, as well as ethics and law. The consortium focuses on reducing the burden of ASCVD. We believe the future of health care is data driven and supported by digital health. Therefore, we hope that our research will not only facilitate CARRIER consortium but may also facilitate other future health care initiatives. %M 36251353 %R 10.2196/37437 %U https://cardio.jmir.org/2022/2/e37437 %U https://doi.org/10.2196/37437 %U http://www.ncbi.nlm.nih.gov/pubmed/36251353 %0 Journal Article %@ 2561-1011 %I JMIR Publications %V 2 %N 1 %P e2 %T Digital Health Innovation: A Toolkit to Navigate From Concept to Clinical Testing %A Marvel,Francoise Adeline %A Wang,Jane %A Martin,Seth Shay %+ Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 601 N. Caroline Street, 7th Floor, Baltimore, MD, 21287, United States, 1 4105020469, fmarvel1@jhmi.edu %K digital health innovation models %K mHealth %K innovation framework %K development of smartphone applications %K wearable technology %K healthcare transformation %D 2018 %7 18.01.2018 %9 Viewpoint %J JMIR Cardio %G English %X Digital health technologies such as smartphone apps, Web-based platforms, and wearable devices are rapidly emerging as promising interventions for acute and chronic disease management, particularly in the field of cardiovascular medicine. However, there is limited guidance on how to effectively develop and rigorously test digital health interventions (DHIs). Through our experience with innovating Corrie, a smartphone-based app paired with a smartwatch and blood pressure monitor for myocardial infarction recovery in the acute setting, we aim to provide a toolkit for navigating the digital health technology development and clinical testing processes. The toolkit consists of 6 steps: step one emphasizes concept generation by defining a specific clinical problem and the existing solutions aimed to address it; step two aims to recruit a multidisciplinary team within an academic institution; step three leverages technology accelerators and industry partnerships; step four develops the digital health technology with continuous feedback from patient and family end-users; step five solicits feedback from a diverse array of stakeholders; and step six performs a clinical study at a single site that, if successful, rapidly scales to multiple sites. DHI development is often a complex and vastly uncharted territory. By exploring the steps we took from concept to clinical testing with the first cardiology CareKit app, we hope to provide useful insights to teams that are starting out on their path to digital health innovation. We emphasize the central importance of embracing transdisciplinary work to move from silos to synergy. %M 31758761 %R 10.2196/cardio.7586 %U http://cardio.jmir.org/2018/1/e2/ %U https://doi.org/10.2196/cardio.7586 %U http://www.ncbi.nlm.nih.gov/pubmed/31758761