Johns Hopkins Associate Professor of Cardiology and Epidemiology, Michael Blaha, MD on the lack of obesity care expertise within cardiology and other key specialties.

Remote Care

UCSD’s Wearable Cardiac Ultrasound Milestone

A team of UCSD scientists took a major step towards changing how, when, and where cardiac ultrasound exams are performed, unveiling the first fully integrated wearable ultrasound system intended for continuous heart monitoring.

UCSD’s wearable ultrasound tech has been in development for several years, releasing a steady flow of improvements (e.g. ultrasound sensor, wearable flexibility and skin adherence, data extraction/calculation), but the device’s new fully integrated design represents a major milestone on its path to becoming a real medical device.

• The wireless ultrasound now combines an ultrasound sensor and small flexible control circuit within a single wearable system.
• That combination freed the ultrasound patch from the cables that it previously relied on for power and data transmission – those cables also kept it from being a “truly wearable device.” 
• Since mobility can create motion problems, the team also added a new machine learning algorithm that automatically analyzes signals and instructs the ultrasound sensor how to track targeted tissues as they move, and then interprets incoming data.

Although there’s more work to be done, the wearable ultrasound now captures signals from tissues as deep as 164 mm (6.45 in), allowing patients and their clinicians to continuously track a range of key cardiovascular metrics for up to twelve hours per session:

• Central blood pressure
• Heart rate
• Cardiac output
• Arterial stiffness
• Ejection fraction
• Stroke volume
• And other physiological signals

The UCSD team next plans to test their wearable ultrasound among larger populations and for a broader range of clinical applications, as they make their way towards real world clinical use and commercialization.

The Takeaway

In recent years we’ve seen echo systems become smaller, more powerful, and easier to use, but cardiac ultrasound is still largely confined to dedicated clinical settings and skilled practitioners.That’s reasonable given the complexity of echo technology and patient physiology, but it also makes UCSD’s latest advancements seem like an important milestone as cardiac ultrasound catches up with other modalities that already have a central role in remote cardiac monitoring programs.

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The Wire

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• Ablation Same-Day Discharge: A new study found that the standardized REAL-AF SDD (Same-Day Discharge) protocol was safe for patients who underwent catheter ablation of paroxysmal and persistent AF. SDD was achieved in 86% of the study’s 1,982 eligible patients (the primary efficacy endpoint), while SDD and non-SDD patients had no differences in readmission rates, subacute complication rates, and freedom from all-atrial arrhythmias. The SDD group, however, showed a lower acute complication rate (0.8% vs. 2.9%).

• Medtronic’s Harmony TPV Outcomes: A pooled analysis from three clinical studies (N=87) revealed encouraging one-year outcomes for patients with severe pulmonary regurgitation (PR) who received Medtronic’s Harmony transcatheter pulmonary valve (TPV). At 1-year follow-up, the FDA-approved device (designed for use in native or surgically repaired RV outflow tracts) led to no deaths, and 91%-98% of patients didn’t experience the composite endpoint of recurring PR, stenosis, and reintervention. 

• Cardiac MRI for Aortic Regurgitation Management: A JACC-published study found that cardiac MRI volume measurements may provide valuable information for managing patients with asymptomatic aortic regurgitation with preserved LVEF. Using CMRI data from 458 patients over a 2.4-year follow-up, the researchers found that CMRI-based indexed LV end-systolic (iLVES) volume of ≥43 mL/m² and indexed LV end-diastolic volume of ≥109 mL/m²  were independently associated with unfavorable clinical outcomes. Importantly, iLVES volume allowed more accurate predictions than iLVES diameter.

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There’s plenty of short term benefits to cardiology data analytics, but it’s just as important for providers to make sure they’re ready for the future of cardiology analytics. This Change Healthcare article with Dr. Jennifer Hall, chief of data science at the American Heart Association, examines what technology leaders can do today to facilitate their future advancements in cardiovascular data and analytics.

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