Quick answer: Heart failure affects around 1 million people in the UK, but roughly half remain undiagnosed despite highly effective modern treatment. New implantable sensor technology, now in UK clinical trials, aims to catch deteriorating heart failure before symptoms even appear — shifting care from reactive to proactive.
A month or so ago I received an email asking if I would give a talk at a conference. The request was from the British Society for Heart Failure (which is the specialist society for this in the UK) and so I was flattered to be asked. I was also a bit nervous. I’m quite comfortable giving talks, but this was to be in front of a few hundred people. It was also rather inconvenient, in as much as the conference was in Cardiff on a Friday morning. I didn’t want to cancel my monthly inherited heart disease clinic the afternoon before, and had another meeting Friday afternoon so this would be an 8 hour round trip for a half-hour talk, and probably a late night.
I was on the verge of politely declining, but something stopped me. I tell my children, and indeed my patients, that it’s good to get out of our comfort zone. That’s often where personal growth lies. If we never did hard things, or things we anticipate might be hard, opportunities would be missed. Facing up to challenges is important, and more often than not, they are not nearly so hard as we might think. Humans are pre-programmed to explore and discover, how else would we have spread all over the world and beyond?
What are implantable sensors for heart failure?
It would therefore have been a bit hypocritical to decline on the basis that I might have been a bit apprehensive about speaking, so I said yes. The topic was ‘implantable sensors for patients with heart failure’, and I’ve been fortunate enough to be involved in the 2 main UK trials of such devices, including the recent ‘first in human’ trial. These sensors will change the way we manage patients with heart failure in the next decade, moving from a reactive situation where we adjust medication only when patients develop symptoms, to one where we can proactively make changes before a patient even knows they are on the road to getting sick. Wearables for all sorts of health conditions from continuous glucose monitors to apple watches are commonplace now. Interpreting the data however and putting it in the correct clinical context is a challenge for the device companies (I often get asked for example about ‘inconclusive’ readings from a smart watch…)
The conference went really well, and oddly I felt pretty much no nerves whatsoever when I gave my talk. Now reading this you may well be thinking that’s all well and good, but I’m not going to get asked to give a talk any time soon so what’s the relevance for me? However, I’m confident if you think hard enough about it, there will be something in your life that you consider hard, or that you have put off for one reason or another. This could be anything, and it will look different for different people (for example my 13 year old son is a good golfer, regularly out-drives me, yet doesn’t want to enter competitions right now probably due to nerves). I would encourage you to stop for a moment, and have a think about how this might apply to you? Is there something at work you are putting off? A healthy habit you’ve been meaning to start? If it does, is there a step you could take to bring you nearer to ‘the thing’?
If you have identified something, I dare you to hit reply and tell me what it is and what you will do. I can’t promise to reply to everyone, but I can promise to read all messages, and I can also promise that by committing to another person that you will do something, scientific research tells us you are much more likely to achieve it. Weirdly us humans find it easier to let ourselves down than someone else!
How common is undiagnosed heart failure?
Conferences such as the one I attended are really important to spread the message about heart failure. It is incredibly common, with over 1 million people in the UK thought to be affected. Around half of these however do not have a diagnosis, meaning many people are walking around with a very treatable condition. In fact, the drugs we have these days for heart failure are amazing, and can reverse it in a significant number of cases. Despite this, access to the correct medication is poor – a recent study looking at GP databases showed that only half of patients who were eligible for a particular medication were actually receiving it! Typical symptoms include breathlessness, swollen ankles, and fatigue. Detection is initially using a blood test called a NT pro-BNP, and then if elevated, leads to an echocardiogram. We can do better!
In this week’s research video, I discuss inflammation and the heart. You will I’m sure of heard of the word, but what does it really mean, and why is it important with respect to the heart? This is a huge topic, but I’ll give you my thoughts on a recent study, and why it may be relevant to you.