Advancing Technologies and the Field of Medicine

Nassir Azimi, MD, FACC, FSCAI, FASNC

As we see technologies advance at a rapid pace over the last two decades, medical care is vastly changing. Patients and their physicians are employing technologies on a daily basis. We have improved diagnostic tools with advanced computed tomography (CT), Magnetic Resonance Imaging (MRI), and ultrasounds. Wearable devices are helping identify conditions earlier and telehealth is allowing providers to reach out to patients who previously were unable or unwilling to travel to clinics, particularly in the rural settings.

Technology is advancing at a rapid pace. We now have watches that record blood pressure, heart rate, rhythm electrocardiogram (ECG) strips, and some can sense and record pulse oximetry (blood oxygen concentration). This by and large helps patients keep track of important vital information. The atrial fibrillation that was often identified after a patient had a stroke as a complication can now be identified incidentally with a watch.

The Kardia mobile app on the smartphone can connect to a small device (carried in one’s pocket) with the ability to record medical-grade 6 Lead ECG. This can help detect atrial fibrillation, bradycardia, and tachycardia. The strips can be transmitted to service for analysis or saved on the device for discussion at a doctor’s visit. We also have implantable loop recorders which can record and transmit abnormal rhythms either respecified by the physician or triggered with a button by the patient. They can help identify the causes of stroke, syncope (passing out), and other dangerous arrhythmias.

The modern pacemaker and or defibrillator is a gem with the ability to do more than pacemaking. They can keep track of information and transmit it remotely via wi-fi. Additionally, some have the ability to let the physician know early if the patient is developing fluid overload from congestive heart failure and thus communicate with the physician so that the patient can be kept out of the hospital.

The CardiMEMS is a sensor device that can be implanted in the pulmonary artery to give information about the patient’s fluid status and once again keep track of the patient with advanced heart failure so that timely intervention could help keep them from hospitalization and help with their symptoms

We have other sensors that help patients on a daily basis. The continuous glucose monitors help keep track of glucose instantaneously and help avoid extreme hyper or hypoglycemic episodes. They can be programmed along with insulin pumps to help regulate patients’ glucose continually. These devices are undergoing constant improvement.

The worldwide web is advancing with more and more information. On a daily basis, my patients are coming to the clinic armed with information. Some have already diagnosed themselves with Dr. Google and want my second opinion. Others have unfortunately been victims of misinformation. Truly the internet has vast information accessible to all seeking it, but unfortunately, it has as much misinformation if not more.

Misinformation exposes patients to real harm. A patient looking up their blood thinner may instead be directed to an attorney add to call 1-800-Bad Drug number which may lead them to wrongly stop their blood thinner before the opportunity to discuss with their physician and this, in turn, could then lead to a stroke. I have personally had my patients stop their statin medication (which for the established patient with high cardiac risk can be potentially life-saving) due to bad press about side effects. For the same reasons, some refuse to use them and hence expose themselves to unnecessary greater harm. The reality of misinformation is magnified through the lens of the COVID-19 pandemic and its vaccine as we see science corrupted by politics.