A year after launching the original HeartLink platform and app supporting the treatment of patients with advanced heart failure, the benefits of their use have been evaluated. The results of the pilot project conducted at Wroclaw Medical University (WMU) proved so promising that further expansion of the app with new functionalities is planned, and potentially its integration into the standard of care for patients with mechanical circulatory support. The project was developed at the WMU Institute of Heart Diseases.
Heart failure is a growing condition, now affecting about 1–2% of the adult population, with 1–10% of patients progressing to an advanced stage, where heart transplantation remains the only treatment improving survival. For some patients, transplantation is not feasible—due to contraindications or the limited availability of donors. In such cases, a bridge solution is the implantation of a left ventricular assist device (LVAD).
The MOMENTUM3 trial showed that two-year survival among patients treated with LVADs is about 80%—roughly double that of patients with advanced heart failure treated conservatively.
– Despite such advanced technology, patients still require frequent outpatient visits and hospitalizations for monitoring of clinical status, pump parameters, wound healing, and treatment optimization, explains Dr. Mateusz Sokolski, cardiologist at the Clinic of Heart Transplantation and Mechanical Circulatory Support, and leader of the HeartLink development team. Patients are often admitted due to complications such as bleeding from anticoagulation, right ventricular failure, or driveline infections.
Continuity of care is key
According to the literature, more than 50% of patients require rehospitalization within the first year after LVAD implantation. Driveline infections occur in about 30% of patients, leading to longer hospital stays, prolonged antibiotic therapy, and sometimes surgical intervention. Many of these complications could be prevented through regular monitoring.
– This need for continuity of care and prevention of complications inspired the idea of creating an app enabling systematic (daily) transmission of pump parameters and basic clinical data, says Dr. Sokolski.
How does HeartLink work?
Using the HeartLink app, patients anonymously transmit data including LVAD parameters and their current health status: blood clotting index, body temperature, driveline site temperature, body weight, and—if possible—blood pressure and heart rate. Patients also report their well-being and confirm medication intake according to their prescribed treatment plan.
– Requiring patients to confirm medication intake aims to improve therapeutic compliance, explains the expert.
Once a week, patients also submit a photo of their driveline wound, which is reviewed by a physician and/or LVAD coordinator, allowing for early detection of potential infections.
Pilot results
The pilot study compared the number of urgent hospitalizations in patients using the app with those receiving standard care but with similar clinical characteristics.
– In the first three months after implantation, the number of unplanned hospitalizations was significantly lower in the app-monitored group, the researcher summarizes.
Effectiveness was assessed based on data from 43 patients at the University Clinical Hospital, out of 81 LVAD implantations performed.
– The HeartLink platform has great scientific potential and may be implemented as part of standard LVAD care in inter-center collaboration, says Dr. Sokolski. For this, the current system must be modernized and a fully secure technical infrastructure created, requiring additional funding. Cybersecurity safeguards will also be essential.
Next steps: modernizing the app
Planned improvements include a machine-learning algorithm that will automatically analyze wound photographs and flag abnormalities.
Such a solution is entirely non-invasive and may improve patient care, reduce costs, and above all decrease adverse events. With modifications, the app could also be used in other patient groups. Development is ongoing in collaboration with the WMU Technology Transfer Center.
The creation of the HeartLink platform and app was made possible by a WMU competitive grant. The research team included, alongside Dr. Mateusz Sokolski, Prof. Michał Zakliczyński, Prof. Roman Przybylski of the University Clinical Hospital, medical students from the Heart Transplantation and Advanced Heart Failure Therapies Student Research Group (Paweł Iwaszkiewicz, Katarzyna Rakoczy, Manuela Makiola), as well as IT specialists responsible for software development.