Northwestern University and Johns Hopkins University will each use recently-awarded grant money to study new atrial fibrillation technology. The National Heart, Lung, and Blood Institute awarded the multi-million dollar grants specifically to develop “pill-in-pocket” strategies to prevent strokes in A Fib patients.
Atrial fibrillation is the most common heart rhythm disorder in adults, and if left untreated, it can lead to blood clots. Blood thinners are the most oft-prescribed medication to treat A Fib. This new National Institutes of Health-funded trial will use an app on Apple Watch to monitor the condition, with hopes that patients can eventually live more normal lives without need for medication.
The trial will last for seven years and cost $37 million. It will use the innovative heart health features on Apple Watch, through a contribution directly from Apple. Patients in the trial will receive feedback from their watches and iPhones; with the feedback they will be able to add or subtract blood thinning medication to their daily regiments based on heart activity.
“If proven effective, this new treatment paradigm will fundamentally change the standard of care for the millions of Americans living with A Fib,” said principal investigator Dr. Rod Passman, director of the Center for Arrhythmia Research.
“Many of these patients are on blood thinners for the rest of their lives even if they have infrequent episodes of atrial fibrillation,” Passman said. “If we can show this strategy is equally protective against stroke and reduces bleeding, that could save lives, reduce cost and improve quality of life.”
Atrial fibrillation cases are going to spike by 400% in the next few years according to estimates, so the grant research will be important in developing treatment options
Currently, medical professionals must use a one-size-fits-all treatment approach to patients with prolonged A Fib. An estimated 12.1 million Americans will suffer from the arrhythmia by 2030, according to estimates. Wearable technology will help tailor specific treatment approaches, since doctors will be able to see daily data.
A lifetime on blood thinners and anticoagulants can cause excessive bleeding during injury, Passman pointed out.
“We think advances in technology will allow us to personalize this care,” Passman said. “Why should patients expose themselves to the risk and cost of these drugs when they may not be benefiting?”
The multi-year trial will study 5,400 patients, randomizing them to receive either the current blood thinner regiment, or the Apple Watch method. The trial will also examine the app’s effectiveness in reducing major bleeding events as compared to pharmaceutical therapy. No matter what course of treatment proves most effective, Passman said the study will reveal much about the nature of A Fib.
“While most data suggest the atrial fibrillation rhythm itself causes the stroke, there’s an alternative hypothesis that the risk remains even when the rhythm itself goes away,” Passman said. “If this strategy is not equally effective, then perhaps we should reconsider whether the rhythm of the heart causes stroke or is simply a marker for some underlying mechanism.”