A project at Oxford University Hospitals NHS Foundation Trust to test how effective smart devices are at detecting heart rhythm problems has received a grant of almost £150,000 from national charity Heart Research UK.
Atrial fibrillation (AF) is the most common heart rhythm problem and is thought to affect around 2 million people in the UK. It causes an irregular and fast heartbeat, which makes the heart pump poorly. As a result, blood clots may form inside the heart and, if they travel to the brain, can lead to an AF-related stroke. The risk of stroke in patients with AF is five-fold higher than in people with normal rhythm.
Anticoagulants play a major role in the management of AF. They work by making the blood less likely to clot which therefore reduces the risk of a stroke. However, anticoagulants make patients more prone to bleeding. A significant number of patients on anticoagulants have a major bleed and some, such as brain bleeds, can cause death or severe disability.
Some people are in AF all the time but many have intermittent, infrequent episodes. Currently everyone is advised to take their anticoagulation treatment all the time so many people end up taking it when the vast majority of the time they are in a normal rhythm.
As AF doesn’t always cause symptoms, we need an accurate and reliable way to detect it and alert the patient, so that anticoagulants are taken only when needed. New technologies, such as small heart monitors placed under the skin, watches and rings, can track the heart rhythm continuously and send alerts.
The Medtronic LINQ II implantable cardiac monitor (ICM) is a device the size of a paperclip that is injected under the skin and monitors the heart rhythm and can accurately detect AF. The latest Apple Watch has the ability to detect AF, as does the Sky Labs CART ring. All of these devices connect to a smartphone.
This study, which is being led by Professor Timothy Betts, will recruit 50 patients with AF and follow them for 6 months. Everyone will receive an ICM. In the first 3 months, Professor Betts and his team will see how well the ICM alerts the patient when AF is detected and how promptly the patient acknowledges the alert. After 3 months, each patient will then be given either a Sky Labs CART ring or Apple Watch which will send alerts during AF episodes. The ICM will continue to monitor AF episodes and the team will see if the ring and watch are as good as the ICM at detecting AF, how well the ring and watch alert patients and if the alerts are acknowledged.
The ultimate goal is to use the data collected to guide anticoagulant treatment so that AF patients take anticoagulation only when they need it.
Professor Betts said: “It is always fascinating to see advances in new technology and the wide range of applications that they can have.
“This project will allow us to understand if these new and innovative technologies can aid us in improving the treatment of the millions of people with AF in the UK.
“If successful, we will be able to tailor treatment to individual patients, increase the efficacy of treatment and reduce unnecessary medication.
“We are extremely grateful to Heart Research UK for funding this research.”
Kate Bratt-Farrar, Chief Executive of Heart Research UK, said: “We are delighted to be supporting the work of Professor Betts and his team, who are using cutting-edge technology to hopefully improve the lives of people living with the UK’s most common heart rhythm problem.
“Our grants are all about helping patients. They aim to bring the latest developments to those who need them as soon as possible. We are confident that Professor Betts’s project can bring about real and tangible improvements in how we treat patients, using technology that is both non-invasive and simple to use.
“The dedication we see from UK researchers is both encouraging and inspiring, and we at Heart Research UK are proud to be part of it.”