One year after the launch of the proprietary HeartLink platform and application, which supports the treatment of patients with advanced heart failure, the benefits of its use have been summarized. The results gathered in a pilot project at the Wroclaw Medical University (WMU) proved so satisfactory that there are plans to expand the application with new functionalities and potentially implement it as part of the standard of care for patients with mechanical circulatory support. The project was developed at the Institute of Heart Diseases, WMU.
The incidence of heart failure continues to rise, currently reaching approximately 1-2 percent of the adult population. Of these, 1-10 percent will progress to advanced stages, where the only treatment that improves prognosis is heart transplantation. However, for some patients, transplantation is unaffordable due to contraindications or a limited donor pool. A bridge solution in such situations is the implantation of a left ventricular assist device (LVAD).
The MOMENTUM3 study showed that the two-year survival rate in the group treated with this technology was approximately 80 percent, which is estimated to be twice as high as in patients with advanced heart failure treated conservatively.
“Despite the use of such advanced technology, patients still require frequent outpatient visits and hospitalizations to monitor their clinical condition, pump parameters, assess the postoperative wound, and optimize treatment,” explains Dr. Mateusz Sokolski, MD, a cardiologist at the Heart Transplant and Mechanical Circulatory Support Clinic and leader of the team developing the HeartLink app. “Patients often require hospital admission due to complications such as bleeding during anticoagulation, right ventricular failure, and feeding tube infections.”
Continuity of care is key
According to literature, hospitalization rates exceed 50 percent during the first year after device implantation. Feeding tube infections occur in approximately 30 percent of patients with LVAD implants. They are associated with prolonged hospital stays, prolonged antibiotic therapy, and in some cases, the need for surgery. Many of these complications could be avoided with regular patient monitoring.
– It was precisely out of the need to maintain continuity of care for patients with LVADs and to prevent complications that the idea of creating an application enabling systematic (daily) transmission of pump parameters and basic clinical data arose – explains Dr. Sokolski.
How does HeartLink work?
Using the HeartLink app, the patient anonymously submits data including LVAD device parameters and parameters related to their current health status, including blood clotting index, body temperature, temperature around the power cord, body weight, and, if possible, blood pressure and heart rate. An additional parameter is an assessment of the patient’s well-being and confirmation of medication intake, in accordance with the individually determined treatment regimen.
– Obliging the patient to verify medication intake is intended to improve so-called “compliance,” i.e. adherence to therapeutic recommendations, explains the expert.
Once a week, the patient is also required to send a photo of the wound within the feeding tube, which is each time analyzed by the physician and/or LVAD coordinator, allowing for the quick detection of any possible infections.
Pilot results
The pilot study within the completed project consisted of comparing the number of emergency hospitalizations in patients using the application and in patients with similar clinical characteristics who received standard treatment.
– It turned out that during the first three months after implantation, there were significantly fewer unplanned hospitalizations in the group with application monitoring – summarizes the researcher.
The effectiveness of the application was verified based on the analysis of a total of 43 USK patients, with 81 implantations performed.
“The HeartLink platform has significant scientific potential, and what’s more, it can be implemented as part of the standard of care for LVAD patients through inter-center collaboration,” announces Dr. Sokolski. “This will require modernizing the current system and creating a fully secure technical base, which in turn requires securing additional funding. Developing appropriate security measures to address the threat of cyberattacks is also crucial.”
Application modernization
Plans for further development of the application include, among other things, developing an algorithm based on “machine learning” that will automatically analyze photographs and signal irregularities in the post-operative wound.
This solution is completely non-invasive and could potentially translate into benefits such as improved patient care, reduced costs, and, above all, a reduction in the number of adverse events. With appropriate modifications, the application could also be used in other patient groups. Further development is being conducted in collaboration with the Technology Transfer Center at the Medical University of Warsaw.
The creation of the HeartLink platform and application was made possible thanks to a competition subsidy from the Wroclaw Medical University. In addition to Dr. Mateusz Sokolski, Prof. Michał Zakliczyński, and Prof. Roman Przybylski from the University Clinical Hospital, the research team included students from the Student Research Group of Transplantology and Advanced Heart Failure Therapies: Paweł Iwaszkiewicz, Katarzyna Rakoczy, Manuela Makiola, and IT specialists developing the software.
photo: Małgorzata Sagan-Nowicka/USK Wrocław
