Mobile health applications in cardiac care

Rapid advances in mobile health technologies and their ubiquitous communication capacity have invigorated remote healthcare delivery. Mobile health applications can help counter the mounting pressure on cardiac services. Patients are increasingly using health and well-being applications, including those for chronic disease monitoring. Population-screening applications are becoming widely used and can have a significant impact on early detection in future. Studies show that cardiology services are using mobile technologies to provide earlier diagnosis through remote transmission and interpretation of ECG, leading to more accurate triage and shorter door-to-balloon time in myocardial infarction. Arrhythmias can be monitored in real time, supported by automated detection algorithms, and implantable device status checks can efficiently and safely be carried out remotely. Ongoing monitoring for and early detection of deterioration in heart failure can also be achieved through mobile applications. Cardiac rehabilitation has been delivered remotely utilizing mobile technologies. Mobile health offers significant potential in providing effective, efficient and appropriately personalized care; however, further studies are required to confirm this. The objective of this review is to explore and describe studies of mobile health applications in cardiac care, including the implications for interventional cardiology, with a focus on clinical outcomes

Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: results from a randomised controlled trial

Objective: Cardiac rehabilitation (CR) is pivotal in preventing recurring events of myocardial infarction (MI). This study aims to investigate the effect of a smartphone-based home service delivery (Care Assessment Platform) of CR (CAP-CR) on CR use and health outcomes compared with a traditional, centre-based programme (TCR) in post-MI patients. Methods: In this unblinded randomised controlled trial, post-MI patients were randomised to TCR (n=60; 55.7±10.4 years) and CAP-CR (n=60; 55.5±9.6 years) for a 6-week CR and 6-month self-maintenance period. CAP-CR, delivered in participants' homes, included health and exercise monitoring, motivational and educational material delivery, and weekly mentoring consultations. CAP-CR uptake, adherence and completion rates were compared with TCR using intention-to-treat analyses. Changes in clinical outcomes (modifiable lifestyle factors, biomedical risk factors and health-related quality of life) across baseline, 6 weeks and 6 months were compared within, and between, groups using linear mixed model regression. Results: CAP-CR had significantly higher uptake (80% vs 62%), adherence (94% vs 68%) and completion (80% vs 47%) rates than TCR (