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By Philip B. Adamson, M.D., MSc, FACC, Divisional Vice President, Chief Medical Officer of Heart Failure, Abbott
Heart disease has been a major healthcare issue worldwide for decades. Nearly a year into the COVID-19 pandemic, experts fear that heart disease is worsening. New research from global healthcare company Abbott found that 78 percent of healthcare providers are concerned that we have yet to see the full extent of COVID-19’s impact on cardiac health and outcomes. In January 2021, the American Heart Association predicted the rate of cardiovascular disease to “grow exponentially” in the coming years due to the realities of the pandemic.
There are several reasons to believe that a surge in heart disease is coming. During the pandemic, lifestyles changed. There are fewer opportunities to exercise safely, with many people leading more sedentary lives, and some people have shifted to less healthy eating habits. We also know that COVID-19 (SARS-CoV-2) has been shown to infect and damage heart tissue in certain cases.
In addition to heart disease, I’m deeply concerned that fewer people are receiving primary care. While we all do our best to safely maintain physical distance, telemedicine is helping to fill the care gap. A recent JAMA study found telemedicine accounted for 35 percent of primary care visits in Q2 of 2020. That is a substantial increase from Q1 of 2020 when only 4.1 percent of primary care consultations were virtual.
The advent of telemedicine should be celebrated, but virtual care can have its limitations. As someone who treated patients with cardiovascular disease for decades, I can tell you that speaking with a patient through their smart phone camera isn’t the same as sitting down with them face-to-face. Yet early detection, such as monitoring blood pressure and cholesterol, are key to managing serious heart conditions. Without these very basic metrics, we are flying blind to a patient’s potentially burbling cardiovascular condition.
While telemedicine fills a critical gap, we need to make sure physicians have the resources to provide adequate virtual cardiac care. This is especially important for complex care patients, like the 6.2 million Americans already affected by heart failure, who need more than traditional physiological markers to receive optimal care. That’s where exciting technologies like remote monitoring enter. According to our research, only 1 in 5 healthcare providers have experience using remote monitoring devices with complex care patients – yet half of those same providers want to be able to treat patients remotely.
A tool developed by my company Abbott, called the CardioMEMSTM HF System, is ideal for remote monitoring in heart failure patients. Traditionally, clinicians have relied on physiological markers including patient weight and blood pressure to detect heart failure. We now know that, for heart failure specifically, these markers provide information too late in the game. By the time these indicators are flashing warning signs, hospitalization may already be necessary. This sophisticated system implants a small, wireless monitoring sensor in the pulmonary artery to directly measure the arterial pressure. The system allows patients to remotely transmit this data from their homes to their healthcare providers.
That insight provides an indication of worsening heart failure and allows physicians to quickly alter treatments for patients virtually – with a boon to improving patient outcomes and avoiding costly hospital visits. This system has already been proven, when managed by a physician, to significantly reduce heart failure hospital admissions and improve the quality of life for people living with NYHA Class III heart failure. In the coming months, we can expect to see results of a landmark clinical trial using the system, which will evaluate improved survival and outcomes for NYHA Class II-IV heart failure patients.
As a physician, I’m incredibly concerned about how COVID-19 is affecting heart health. On top of routine doctor visits being canceled, there is emerging evidence that the virus is negatively influencing heart health by directly damaging the heart, causing people to delay care, and negatively influencing lifestyle changes.
While the medical community has quickly adapted to the realities of the pandemic and has largely embraced telemedicine, we need to continue to innovate how patients are treated. We must implement technologies like remote monitoring to provide optimal care to our patients who need it most. Otherwise, when we come out of the pandemic, we will be dealing with another epidemic providers are already recognizing – a dramatic surge in heart disease.
About Dr. Adamson
Philip B. Adamson, MD, MSc, FACC is divisional vice president and chief medical officer of Abbott’s heart failure business. He is responsible for global development of Abbott’s heart failure programs, including cardiac resynchronization therapy, the CardioMEMS HF™ system and its Mechanical Circulatory Support portfolio, including the HeartMate 3™ heart pump.
Dr. Adamson joined Abbott, formerly St. Jude Medical, in February 2015. His clinical interests focus on development of more efficient and effective disease management systems for patients with chronic heart failure, specifically focusing on remote monitoring of physiologic signals from implanted devices.
Prior to joining Abbott, Dr. Adamson helped developed a novel cardiology training curriculum designed to provide skills in device implantation and management along with expertise in out-patient multidisciplinary disease management program development. He has served as the Principal Investigator on the Steering Committees of several large randomized clinical trials. In this capacity he was the Co-PI of the CHAMPION Trial, which demonstrated the efficacy and safety of the CardioMEMS HF™ System, leading to FDA approval of the system in May 2014.
Dr. Adamson received his M.D. and Masters of Science in Cardiovascular Physiology and heart failure from the University of Oklahoma Health Sciences Center. He joined the faculty at the University of Oklahoma as a Warren Foundation Investigator and received funding to develop a novel model of ischemic heart failure that served to investigate the autonomic mechanisms of sudden cardiac death. Dr. Adamson remained on the faculty for more than 20 years. He holds a Bachelor of Science with dual majors in Accounting and Physiology from the University of Central Oklahoma.
Dr. Adamson has been nominated to be a Fellow of the Royal College of Physicians in Edinburgh (UK). He also remains an Adjunct Associate Professor of Physiology at the University of Oklahoma Health Sciences Center.
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