In recent years, remote monitoring technology of all kinds has advanced by leaps and bounds. As with many healthcare technology categories, more remote monitoring means better care with an even greater ability to tailor interventions to the unique needs of each patient. For providers, remote monitoring technology represents new visibility that can assist in diagnosis, treatment, and the ongoing management of chronic conditions. In no area is this transformation more palpable than in cardiology.

The Shortcomings of a Snapshot-Based Approach

Historically, most remote ECG systems, or cardiac event monitors, only offered a “snapshot” of cardiac activity, neglecting to provide a complete picture of a patient’s heart health. Monitoring devices recorded small segments of data, and did so only during cardiac events or when the patient initiated recording. Patients were then responsible for bringing devices to their physicians. If an event did not occur during the recorded period, no diagnosis could be made.

Even if an event was recorded, many conditions cannot be diagnosed based on a single short-term event. Accurate diagnosis, particularly when condition complexity is high, often requires longer-term monitoring that occurs over days or weeks. Together, advancements in wireless data transmission, data storage, anomaly identification, and patient usability, mean virtual cardiac telemetry is now capable of true 24/7 monitoring, better known as full disclosure.

What is Full Disclosure?

Full disclosure is the recording and reproduction of every single heartbeat, including onset, offset, and event confirmation data, every single minute of the day. It offers providers the unprecedented ability to gain instant access to every last byte of heart data and to analyze that raw data in context, which is an invaluable aid in diagnosis.

When equipped with the capacity to provide every beat and event in context, a cardiac event monitor transforms from a somewhat monolithic tool to a dynamic one. It aids in identifying deteriorating and life-threatening conditions, facilitates the management of arrhythmias, and enables cardiac health to become an integrated part of multi-disciplinary care. While early efforts at remote monitoring relied heavily on a patient participation and demonstrated limited success, emerging technologies that utilize machine learning are capable of detecting precursors of heart failure with 76% to 88% sensitivity.

Why is Full Disclosure Important?

Full disclosure data is not just important; it is truly vital—no pun intended. In the case of sudden cardiac arrest (SCA), every minute that a patient goes without defibrillation decreases their chances of survival 7 to 10 times. Reducing the time to defibrillation is critical—not only because 75% to 80% of non-hospital SCAs happen at home, but because receiving defibrillation within two minutes after the event gives patients the best chance of survival.

Continuous remote cardiac monitoring that offers full disclosure can alert medical teams in advance of SCA, thereby improving timeliness with which a patient can receive lifesaving care. While full disclosure has a clear application for patients suffering SCA, some of its applications are far more nuanced. Let’s explore three specific scenarios that demonstrate the importance of full disclosure in cardiac care.

1. Identifying patients experiencing paroxysmal atrial fibrillation

While atrial fibrillation, or afib, is one is one of the most common types of arrhythmias in the United States, acute cases of irregularity can be extremely difficult to identify, monitor, and properly diagnose. For example, in the case of paroxysmal afib, patients have very intermittent episodes.

Despite advances in monitoring technology, algorithms can only go so far in accurately defining the starting and stopping of such episodes. In some instances, a full disclosure perspective can be much more effective in understanding the dysrhythmia, as it is inherently better at accounting for evaluation of time, duration of event, prevalence of irregular episodes and more. 

Additionally, some monitors, like InfoBionic’s MoMe™ ARC platform, provide a 6-channel view, which provides increased clarity and a fuller picture of patient heart health relative to devices with fewer leads.

St Segment
Symptoms of chest pain with significant ST segment changes.

2. Detecting atrial tachycardia with a consistent RR interval

Like afib, Atrial tachycardia with a consistent RR interval, or atrial flutter (AFL), is a type of abnormal heart rhythm that impedes the heart’s ability to pump blood effectively. However, it describes a condition where the interval of each heart beat remains relatively regular.

Due to this regularity, the event trigger algorithms present in many remote ECG monitoring systems fail to pick up on any meaningful deviation (measured in time). If left untreated, AFL can damage the heart muscle and increase the risk of stroke or blood clots. For patients and providers with devices leveraging full disclosure, identifying these changes is greatly aided by the ability to compare heart rates (HR) over a 24-hour period.

Atrial Flutter
Visualization of trend graph displays enable accurate ECG data processing and identification of Atrial Flutter.

3. Realizing the benefits of tracking heart rate trend over time

Just like with in-patient hospital telemetry, which has no lapse in monitoring, full disclosure data enables providers to readily scan, analyze, compare, and record 24 hours’ worth of HR trends to quickly identify anomalies.

For example, an event style trigger notification would not alert the provider of an insignificant HR deviation. Conversely, a full disclosure observer could easily appreciate a change in the HR trend graph over 24 hours to surface even small changes in HR. The power of this data only increases when the HR trend data extends beyond 24 hours. While this data represents a far greater volume, AI-assisted automation like that provided by the MoMe™ ARC Platform can help dramatically simplify interpretation and analysis.

When harnessed properly and supplied with sufficient data fidelity and volume, AI can empower data-driven decisions to evaluate disease progression or select the most appropriate treatment for a cardiac patient.

The VT triggered event related to artifact shows the importance of the 6-lead view.

Full Disclosure: The Heart of the Matter

The importance of full disclosure cannot be overstated. It is key to providing cardiologists a full, unobstructed view of heart health—including the information that might be altogether overlooked by traditional monitoring solutions. 

InfoBionic’s MoMe™ ARC Platform takes full disclosure to new heights with best-in-class AI that accesses the highest fidelity ECG data. Our remote cardiac monitoring platform aims to replicate in-hospital monitoring with a continuous monitoring model that shortens the distance between physicians and their patients, giving them richer control and deeper insight to make better decisions.

With the MoMe™ ARC Platform, providers can see beyond reported events and verify what they suspect with the ability to access any data from the monitoring period. With the ability to view what happens before and after events, providers can better identify triggers and correlate symptoms to rhythms. No other service provider offers access to onset, offset, and event confirmation data—detailing every heartbeat.

Contact us to discover how you can access full disclosure data to strengthen your cardiac patient care.