Medical Devices & Technology Archive

In the 1950s, doctors offered mainly morphine and bed rest — a far cry from the many procedures and medications provided today.

During a round of golf one autumn afternoon in 1955, President Dwight Eisenhower experienced what he assumed was indigestion. After he awoke at 2 a.m. the following morning with severe chest pain, his personal physician administered several shots of morphine. It wasn't until 1 p.m. that afternoon that an electrocardiogram revealed that the president had experienced a heart attack.

Cardiologist Dr. Thomas Lee, professor of medicine at Harvard Medical School, detailed Eisenhower's experience in the Oct. 29, 2020, issue of The New England Journal of Medicine. His piece focuses mainly on how Eisenhower's cardiologist, Paul Dudley White, communicated the event to the public. As Dr. Lee wrote, "Heart attacks became less mysterious and frightening to millions of Americans that day."

Learn when, how, and why you should keep track of your heartbeat.

Soon after you wake up tomorrow morning, before you even sit up in bed, take your pulse. It's fairly easy if you have a clock or timer nearby (see "Measuring your heart rate"). Known as your resting heart rate, this value ranges from 60 to 100 beats per minute in most adults.

"To get a good sense of your resting heart rate, check it every few mornings over the course of several weeks," advises cardiologist Dr. Aaron Baggish, director of the Cardiovascular Performance Program at Harvard-affiliated Massachusetts General Hospital. It's best to measure your resting heart rate when you've been getting your typical amount of sleep and exercise and aren't feeling ill or dehydrated.

News briefs

If your doctor or pharmacist offers a service to monitor blood pressure measurements you send from home (called telemonitoring), consider taking advantage of it. Past research has shown that telemonitoring — often paid for by Medicare — may help you reduce your blood pressure. And a study published online Aug. 31, 2020, by Hypertension suggests telemonitoring is also associated with a long-term reduction in heart attacks, strokes, and medical costs. The recent study is a follow-up to a randomized controlled trial from 2013 that divided 450 people into two groups: those who received routine primary care, and those who received a year of telemonitoring services with a pharmacist who helped manage their treatment. People in the telemonitoring group had lower blood pressure for up to two years afterward, compared with people who received routine care. In the recently published follow-up, which followed the same participants for five years, researchers found there were about half as many heart attacks, strokes, and hospitalizations in the telemonitoring group as there were in the group that received routine care. Because there were fewer cardiovascular problems, people in the telemonitoring group also saved an estimated $1,900 each in medical costs.

The COVID-19 pandemic has prompted a surge in telemedicine visits. Here's what you need to know about virtual health care.

Telemedicine — interactions with your doctor by video — has been slowly growing for years. But when the COVID-19 pandemic hit the United States earlier this year and forced people into isolation, this emerging form of virtual health care took off.

"In 2020, we've seen a sharp hockey stick–like movement in the number of telemedicine visits," says Dr. Joseph Kvedar, a dermatologist with Harvard-affiliated Massachusetts General Hospital and president of the American Telemedicine Association. "The experience has shown both patients and doctors the many ways telemedicine can improve health care in the current environment and beyond. It appears to be here to stay."

Atrial fibrillation can be dangerous from a fast heart rate and a higher stroke risk

Is atrial fibrillation serious? People who are old enough to remember the sound of wind-up clocks often refer to their hearts as their "tickers." It's an affectionate term that pays tribute to the regular, rhythmic beat of the healthy heart. In fact, though, the healthy heart is much more sophisticated than the most precise Swiss timepiece.

Instead of maintaining a single, monotonous beat, the heart can speed up in response to exercise, strong emotions, and fever. Common chemicals can also jack up the heart rate; examples include caffeine, nicotine, and decongestants. And the healthy heart can also slow down when you rest, relax, or sleep.

Studies of drugs, diets, and devices all come with their own unique set of challenges.

The best way to know if a new medical treatment truly works is with a randomized controlled trial — the "gold standard" of research studies, also known simply as a clinical trial. Volunteers are randomly assigned to receive either the new treatment or the comparison, which may be a placebo (an inactive therapy) or a treatment that's already available.

As the nation's top cause of death, cardiovascular disease has been at the leading edge of evidence generation, says Dr. Robert Yeh, director of the Smith Center for Outcomes Research in Cardiology at Harvard-affiliated Beth Israel Deaconess Medical Center. "We probably have more evidence for cardiovascular treatments than for any other field of medicine," he says. Among the studies with the greatest impact were the clinical trials that heralded new therapies to treat heart attacks. These include clot-dissolving drugs in the 1980s, followed in the 1990s by artery-opening angioplasty procedures, which remain the standard of care today. Stents, the tiny mesh tubes used in these procedures, have also been extensively studied in clinical trials (see "Testing devices: Different dilemmas").

On call

Q. Exercise guidelines recommend a certain number of hours per week, depending on whether it's moderate or vigorous intensity. So how do I measure exercise intensity?

A. Outside of a physiology laboratory, there really is no standard agreement on how people should gauge their level of exercise intensity.

Research we're watching

Most home blood pressure monitors sold in Australia are not carefully tested for accuracy, according to a study published online April 10, 2020, by the journal Hypertension.

Because more than 90% of the devices the researchers studied were purchased from international online platforms such as Amazon and eBay, that means many devices purchased in the United States and elsewhere might give inaccurate readings, the authors say.

Learn about a device's pros and cons so you're not stranded.

John was in trouble: The 84-year-old wound up on the floor after sliding out of a chair. While unhurt, John couldn't get up. He lived alone and couldn't reach his cellphone, house phone, or alert button; all were on a table next to his chair. After three long hours trying to inch across the floor, John remembered that his "smart" speaker (activated by voice commands) was connected to his smartphone. John called out for the speaker to dial his daughter, who sent help right away.

Electronic gadgets like smart speakers can be a great addition to the home.  But a smart speaker won't save the day in every emergency. Before investing in a gadget for security, learn about its potential limitations.

Research we're watching

Smart watches and wrist-worn fitness trackers that estimate your heart rate appear to be reliable in people with a range of different skin tones. But their accuracy may vary during different types of everyday activities, a new study finds.

Researchers recruited 53 people with different skin tones to test six different devices, which work by measuring changes in blood flow through the skin using a special sensor. The volunteers also wore electrocardiogram patches (which provide a gold-standard heart rate measurement) while they did different activities: sitting still, breathing deeply, walking, and typing.