Getting back in the game with digital technology

Seasoned runner David Castle was perplexed when his performance suddenly started declining. He pushed himself harder until a couple of intense workouts left him fighting for breath. An underlying heart condition was the last thing on his radar. Below he shares his story with MedTech Views on World Health Day.

“The first time I couldn’t breathe I thought I was having an asthma attack,” David remembers. “But then about four weeks later it happened again and I decided to see the doctor. I’d also been feeling lightheaded and dizzy for a while, but I didn’t think it was anything serious. Over the next three months, I had loads of tests including chest x-rays, electrocardiograms and asthma tests, but they didn’t find anything. Then they suggested I wear a Holter monitor.”

A Holter monitor is a portable type of electrocardiogram (ECG) that continuously records the electrical activity of your heart for a prolonged period. This medtech allows doctors to detect abnormal rhythms that happen only occasionally and may not be picked up by a standard ECG. “I wore the monitor for 24 hours and during that time my heart had stopped for 11 seconds, which is a long time” he says. “I was booked in for a pacemaker fitting ten days later.”

The small, battery-powered device was implanted under David’s skin below his collarbone. It sends tiny electrical impulses to his heart through leads (wires), correcting his low heart rate (bradycardia) and ensuring his heart beats at a healthy pace. “It’s connected to an app via Bluetooth and every six months the hospital can dial in to the app and see my records,” explains David. “I was awake during the three-and-a-half-hour procedure and back home that afternoon. The cause of my bradycardia was ‘sick sinus syndrome’, where my heart’s natural pacemaker, the sinus node, wasn’t working properly.”

During the procedure they also did an angiogram to make sure there weren’t any other issues with David’s heart. This involved the insertion of a catheter (tube) into his wrist which was guided to his heart. A contrast dye was then injected into his arteries, allowing doctors to see the blood flow on an x-ray and identify any potential vessel obstructions, but none were found.

It took David around four weeks to start exercising again. “I found some online forums where other athletes had been fitted with pacemakers, which was helpful for getting advice on how to proceed post-op,” he notes. Digital health has played an important role in his diagnosis, treatment and recovery.

“I’ve learned to experiment and keep an eye on my heart rate with a Bluetooth monitor. There are things that I can and can’t do with the pacemaker. Exercises like burpees where my body position is compromised are quite challenging. It works better with exercise that requires a constant energy demand, like running. I understand that if I didn’t have the pacemaker, I wouldn’t be here. I’ve made peace with the fact that I need to take more breaks and adjust my expectations.”