Reviews Examine How Digital, Mobile Advances Will Define Future of Cardiology

The future of cardiovascular care will be transformed by advances in artificial intelligence, digital health technology and mobile as a means to prevent and treat cardiovascular disease, according to three review articles published June 4 in the Journal of the American College of Cardiology.

Artificial Intelligence in Cardiology: Kipp W. Johnson, BS, et al., analyze select applications of artificial intelligence in cardiology and identify how the specialty could incorporate more artificial intelligence in the future to enhance the capabilities and experiences of clinicians and patients. According to the review, artificial intelligence is currently only performed by those with specialized training, but in the future, these methods will be increasingly easy and widely available. It may eventually be incorporated into day-to-day practice by interacting with electronic health records and billing. “[Artificial intelligence] has clear potential to enhance every stage of patient care – from research and discovery, to diagnosis, to selection of therapy,” said Joel Dudley, PhD, senior author of the review. “A key next step to incorporating artificial intelligence into cardiology is to align available data and technologies with clinical and business use. This way, we can prioritize short-term opportunities and understand gaps in available data or algorithms that are holding back applications of artificial intelligence in areas of high clinical need.”

Using Digital Health Technology to Better Generate Evidence and Deliver Evidence-Based Care: Abhinav Sharma, MD, et al., had previously participated in a 2016 think tank on digital health and discuss the purpose and findings of the meeting in the review article. They had convened to understand the current landscape of digital health technology use in health care delivery and clinical trials, identify issues and barriers to the development and adoption of these technologies, and identify potential solutions. These solutions include developing innovation networks to rapidly test new innovations, validate findings and provide value cost-effectiveness data; collaborating with regulatory agencies to streamline development; working with professional societies to identify critical knowledge gaps that could be filled by digital health technologies; and expanding the role of public-private partnerships. “These technologies could facilitate and advance more conventional randomized clinical trials (RCTs), which is particularly necessary since RCTs are becoming increasingly expensive and complex, are slow to complete and take an extensive amount of time to implement into practice,” Sharma said.

Mobile Health Advances in Physical Activity, Fitness and AFib: Moving Hearts: Michael V. McConnell, MD, FACC, et al., provide an update on cardiovascular mobile health, with a focus on research and clinical advances in measuring and promoting physical activity and fitness plus using these same mobile devices for heart rate and rhythm monitoring, especially for atrial fibrillation (AFib). They explain that ongoing monitoring with mobile health devices is an opportunity to prevent strokes, manage symptoms and reduce hospitalizations from AFib and that machine learning has emerged as a powerful technology to enhance AFib detection from wearable devices. Importantly, physical activity and fitness are also linked with primary prevention of AFib and reduced AFib burden and recurrence. The authors note the importance of broad collaboration to further integrate mobile health technology into clinical care, with the potential for substantial individual and societal benefits. “Only recently has the medical community started to embrace the reality that most ‘health’ takes place outside the hospital and clinic, namely the daily activities and clinical events that occur ‘the other 362 days’ per year when people are not seen by a clinician,” said McConnell. “Enabling patients and clinicians to leverage these technologies for proactive health care can transform cardiovascular prevention and disease management.”

Clinical Topics: Arrhythmias and Clinical EP, Diabetes and Cardiometabolic Disease, Prevention, Atrial Fibrillation/Supraventricular Arrhythmias, Exercise

Keywords: Atrial Fibrillation, Heart Rate, Artificial Intelligence, Telemedicine, Stroke, Patient Care, Electronic Health Records, Biomedical Technology, Primary Prevention, Hospitalization, Disease Management, Exercise

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