Cardiovascular disease (CVD) is the leading cause of death globally, with around 17.9 million people succumbing to it every year. CVD comprises a group of disorders of the heart and blood vessels. The well–known types of CVD include coronary heart disease, cerebrovascular disease, rheumatic heart disease, stroke, and so on. It is also the major contributor to disability and requires long–term treatment for its management.
CVDs were treated using standard surgical procedures and drugs in the past, but these have now undergone a revolutionary change to improve patients’ quality of living.
Innovative Treatment Approach in Cardiology- Technological development in the past few decades has led to advances in the management of CVD to address the growing challenge of CVD.
Read more about cardiovascular disorders
Some of the noteworthy innovative treatment approaches that have recently come into existence are-
1. Miniature Ventricular Assist Device:
This ventricular assist device (VAD) was developed to prolong patients’ lives and improve their quality of living until a heart donor is found. In contrast to the earlier versions that were bulky and required the patients to ambulate with heavy, large external batteries, this VAD has several revolutionary improvements. It has better battery reliability, smaller size, and wireless charging technologies making it physically unnoticeable.
2. Organ Conformal Electronics :
These are flexible, stretchy electronic devices that comprise various sensors and transducers to diagnose and treat heart malfunctions. They help monitor multiple parameters to monitor and regulate cardiac tissue functions by following the shape of the epicardium or endocardium.
3. Mitral Valve Modulation and Repair:
Transcatheter Mitral Valve Repair (TMVR) is a rapidly expanding technology that can become alternatives to surgery for patients with mitral regurgitation. TMVR devices are differentiated based on the portion of the valve they are intended to repair. Although these devices seem promising by offering a minimally invasive approach, their long–term sustainability and effectiveness are yet to be determined.
4. Cardiac Decellularization and Engineered Heart Tissue:
Another promising novel approach that has is emerging nowadays is the use of tissue regeneration techniques to treat heart diseases. This technique employs scaffolds (biomaterials needed for attachment to human cells and support), cells, and appropriate growth factors to reconstruct new tissues. However, the major challenge of this approach is the generation of the ideal scaffold. A decellularized heart composed of a native extracellular matrix is the best natural scaffold that offers the desired physical and chemical signals needed for cardiac functioning.
5. Small, Portable Extracorporeal oxygenation (ECMO) Devices :
These small devices are used as a bridge option for patients recovering from heart failure or heart surgery. It generally provides ventilatory support in critical cases, but newer devices are now aimed at providing both ventilator and circulatory support. ECMO devices are of great value to patients with hemodynamic compromise, especially if the intra – aortic balloon pump is unsuitable.
6. Innovative Treatment Approach in Cardiology-Engineered Heart Valve:
As the name suggests, these valves are made using an in situ tissue engineering approach. Owing to the global burden of congenital or acquired valve defects, bioprosthetic or mechanical valves were developed. These, however, have their limitations, mainly when used in pediatric patients who continue to grow. A tissue-engineered heart valve, in contrast, can serve as an attractive alternative to such patients as they grow and last a lifetime by acting as a living implant. This cardiac technology is currently under development, with preclinical studies being carried out at different global sites.
7. Artificial Intelligence to Predict Cardiac Arrhythmias:
Rhythm disorders of the heart have been widely treated using implantable cardioverter defibrillators (ICDs). Albeit this, it is still challenging to determine which patients will benefit from these devices. In patients without ICDs, external defibrillatory shocks are used to restore the heart rhythm shortly after the onset of the episode. Despite this, predicting the upcoming life-threatening arrhythmias still poses a challenge. However, with the development of computational tools such as artificial intelligence (AI), this could be possible. The use of machine learning-based diagnostics in cardiology and wearable cardiac monitoring devices and the implementation of AI in this field are currently being explored for preventive and therapeutic interventions.
8. Magnetic Navigation and Robotic Systems:
Targeting the appropriate causative tissue to destroy them in catheter ablation is difficult due to the constraints in the technological advancements in this area. This subsequently increases the patient’s exposure time to radiation during the ablation procedure. However, the use of electrophysiologic mapping together with robotic navigation systems can lead to more precise ablation procedures even in complex cases.
9. Pluripotent Stem Cells and Transdifferentiated Cardiomyocytes:
Innovative Treatment Approach in Cardiology- Cardiac devices, albeit being plenty in number, suffer from some major drawbacks. These include the need for battery replacement, lead failure, infections, and limited applicability in young patients. However, the use of pluripotent stem cells technologies and transdifferentiation approaches in place of these devices could seem more promising, especially in treating bradyarrhythmias and heart failure. Read more about Arrhythmia: When the heart rhythm goes for a toss!
These approaches are currently undergoing preclinical studies, but further studies to validate their long–term safety and graft survival need to be conducted before considering these as an alternative for electrical cardiac pacemakers.
10. App to prevent stroke – FibriCheck:
This is the first smartphone app that has received the Food and Drug Administration’s (FDA) approval to detect heart rhythm disorder. It helps to prevent stroke by detecting atrial fibrillation and other heart rhythm disorders by using a smartphone or a smartwatch. This app measures the patient’s heart rhythm per minute, and a detailed report of this followed by the immediate actionable results are also provided. It also enables the users to track their heart rhythm history and look back at how it has changed over a set period. FibriCheck was co – founded by Bieke Van Gorp and Lars Grieten in Belgium.
11. Cardiac implant to treat strokes:
Ireland – based company, AuriGen Medical, has developed a cardiac implant to treat both the stroke and arrhythmia associated with persistent atrial fibrillation. It employs single-use sensors and software algorithms to provide feedback on the quality of ablation cardiac treatment needed to correct certain types of abnormal heart rhythms. The first human trials of this device began in 2020 by using the funding obtained as a part of the EIT Health–supported fellowship program.
12. Software-based stroke rehabilitation therapy – Vigo:
Vigo is a digital rehabilitation program for stroke victims. It is an individualized program, including physio and speech therapy and an exercise plan to enable a faster recovery time. This software provides the user important information about life after stroke, emotional support. It equips them with the skills they may need to tackle people’s many challenges after a stroke. It also offers psychotherapy tools based on counseling and cognitive behavioral therapy.
13. Novel surgical approaches:
Unlike the traditional transcatheter aortic valve replacement (TAVR), the transcaval TAVR uses the vein to guide the catheter rather than the artery. The wire and the small catheter travel to the abdominal area. The catheter creates a passageway between the now–dilated vein and the main artery to pass the new valve’s sheath for the replacement to occur.
This device is a less invasive option for patients with mitral regurgitation who are too sick to opt for open-heart surgery. It is delivered to the left ventricle of the heart via a catheter, where the clip is positioned to ensure that it grasps the valve’s leaflets and controls blood flow.
IN.PACT Admiral drug-coated balloon is a breakthrough approach in treating peripheral artery disease in the upper leg. Angioplasty done using this balloon provides significantly better outcomes as the balloon delivers a drug to the artery walls to prevent the artery from narrowing again.
Conclusion :
Innovative Treatment Approach in Cardiology- Technological advancements in the last 25 years have created a significant impact in the field of cardiology. This has changed how CVDs are treated, making them simplified and economical. However, these innovative advancements have not yet come to fruition, as many more therapeutic approaches are currently under development. All in all, it can be said with certainty that several cutting–edge advancements in the field of cardiology will be witnessed in the coming years. These will aid in putting the innovation in the hands of those who may benefit.
References : [1], [2] [3]
