Monitoring device helps reduce hospital stays, complications

by Natalie Paddon, The Hamilton Spectator

January 23, 2019


Dr. Jeff Healey, director of arrhythmia services and associate professor of medicine at McMaster University, discusses a remote heart-monitoring device with patient William Hope. After his heart surgery this past fall, Hope was back home the next day. – Barry Gray,The Hamilton Spectator

A research project underway at Hamilton General Hospital is making it easier for patients to recover at home after undergoing minimally invasive heart surgery.

Through a partnership with local company m-Health Solutions, patients can wear a remote heart monitoring device for two weeks after undergoing a transcatheter aortic valve implantation.

“We always think of the hospital as the only place where we can offer care to patients,” said project lead Dr. Madhu Natarajan. “But technology is changing rapidly and there are ways of safely diagnosing and managing patients outside the hospital.”

The procedure known as TAVI is performed on patients too frail to have open-heart surgery. The mean hospital stay after the surgery is three to nine days.

For 87-year-old William Hope, his October surgery was “like a miracle.”

For six weeks prior, the Niagara Falls man experienced shortness of breath while walking and raking his lawn.

When he came out of the operating room after the procedure and his daughter asked how he was feeling, he sat up in bed and realized he could take a deep breath again.

“I felt better instantly,” he said.

He went home the following day with the portable heart monitor, which he had to wear for two weeks, and told his family he’d be OK on his own.

The next day, he was back out walking.

Getting older patients home helps to reduce possible side effects of being hospitalized such as falls and confusion, said Natarajan.

“If you’re actually able to get them to their home environment, be with their family, but still keep an eye on them — that’s great,” he said.

Already, three quarters of patients who undergo TAVI surgeries at Hamilton General Hospital go home one day after surgery, but the smartphone-sized monitoring device provides a “layer of safety,” he said.

Data from the patient is transmitted through the device in real time after they’ve left the hospital, helping to reduce stays, re-admissions and complications, said Dr. Jeff Healey, director of arrhythmia services and associate professor of medicine at McMaster University.

A cardiologist would be notified if there is an “urgent finding” in the data and the patient would be contacted and directed on what to do, he said.

Oftentimes patients experience symptoms like dizziness and chest pain, which will send them back to the hospital.

With the monitoring system, patients can communicate through the device and doctors can monitor the data to see what’s happening, Natarajan said.

Natarajan, who is the principal investigator on REdireCT TAVI, said the clinical trial also includes pre-procedural monitoring to identify which patients will require a pacemaker.

The two-year study received funding last year and is being managed through the Population Health Research Institute, which is affiliated with the academic teaching hospitals of Hamilton Health Sciences and McMaster’s Faculty of Health Sciences.

The goal is to recruit 240 patients for the project, said Natarajan. So far they have 50, he said.

He said he hopes to have project results by the spring of 2020.

Original article: The Spec