On the pulse: What an ‘electrician of the heart’ reveals about Australia’s cardiac care

Dr Adam Lee has a memorable way of explaining his job. As a cardiac electrophysiologist, he likes to think of himself as an “electrician of the heart”. Lee specialises in the electrical system of the heart, diagnosing and treating abnormal heart rhythms known as arrhythmias.

It’s an area of cardiac care that has evolved significantly with advances in medical technology. Today, technologies such as remote monitoring are creating new ways for healthcare teams to stay connected with patients and monitor aspects of their heart health beyond the clinic.

For Lee, these advances represent an important shift in how cardiac care can be delivered, complementing in-person care and helping healthcare teams stay connected with patients over time.

But depending on where you live, cardiac technology can play a large role in supporting cardiac care, with remote monitoring helping to give patients peace of mind that potential issues may be identified earlier and that follow-up care is provided sooner, alongside care teams and occasional in-person appointments.¹

“If you look at any public or private hospital, cardiology is always one of the biggest departments,” Lee says. “And in terms of the number of admissions for various medical conditions, cardiology is right at the top.”

Tanya Hall, founder and CEO of Hearts4heart, a national patient-led charity, says heart health remains a major issue in Australia.

“Heart disease kills one person every 12 minutes – over one in five deaths nationally,” she says.

What’s important to understand, Hall says, is that heart disease isn’t just one condition – it’s an umbrella term that includes coronary heart disease, heart failure, heart-valve disease and heart-rhythm disorders such as atrial fibrillation.

In Lee’s line of work, he’s most often confronted with atrial fibrillation, rates of which he describes as “essentially an epidemic” – partly because of the prevalence of lifestyle factors like poor diet, lack of exercise and alcohol consumption, which increase the risk of the condition occurring.

The regional healthcare divide

The data shows that Australians living in rural and remote areas experience rates of cardiovascular disease almost 12 per cent higher than those in metropolitan areas.

Those living in rural and remote regions of Australia don’t just face higher levels of cardiovascular disease, they also contend with more problems when trying to access care, Hall says. Those include “greater challenges accessing cardiologists and other specialists, with longer travel distances, fewer local services and longer waits for appointments”, all of which can make timely diagnosis, treatment and ongoing follow-ups much more difficult.

In fact, while the Medtronic survey found that while cost and distance are often seen as the main barriers to heart care,² many Australians instead face uncertainty about what happens next – including referrals, follow-up and where to access ongoing support.

Lee says he’s noticed that GPs in rural and regional areas are less likely to refer patients to specialist care, because of the practicalities of them attending those appointments.

Closing the distance with medical technology

But one significant development Lee has seen in his career for those managing heart conditions in regional Australia has come in the form of remote monitoring. In the past, patients managing arrhythmias had to visit their specialist annually for simple routine checks.

“And that’s fine if you’re in the city,” Lee says. “But in rural and regional settings, that was very tough because often patients had to travel hours to get to a cardiologist capable of performing that service.”

With remote monitoring, data from a patient’s cardiac device can be securely transmitted to their healthcare team via a cellular or internet connection for remote review, potentially reducing the need to travel for some routine checks.

Lee says it can make a big difference for many patients.

There remains an opportunity to build awareness of the technologies available to support ongoing, connected heart care. A recent Medtronic survey found more than two in five (42 per cent) Australians aged 18 plus are unaware that heart devices can be monitored remotely.²

Awareness extends beyond technology, too. The same survey found only 30 per cent of Australians feel confident recognising a serious heart-related symptom, highlighting the importance of broader heart health education.

Lee says the number-one red-flag symptom to watch for when it comes to your heart is chest pain, which could signal a heart attack. Severe palpitations, like a very rapid heart rate that makes you dizzy, or any episodes of suddenly passing out, also require medical attention.

Lee says anyone over the age of 40 should have regular check-ups with their GP to understand and manage their risk of cardiovascular conditions such as heart attack and stroke. Because, as is the case with most medical conditions, “the earlier you seek treatment, the better your long-term outcomes”.

Lee is excited about the future of remote monitoring in complementing existing care, supporting greater connectivity between patients and their healthcare teams, and potentially reducing the need for some routine in-person checks. Lee says, “It would really make the need for [some] in-person checks almost redundant”.

It’s not a silver bullet for the disparity between those in regional and metropolitan locations, but it is a huge step forward.

“There’s no way that someone who lives in the middle of nowhere that has no hospital around them can get the same care as someone who lives in Pyrmont, in metropolitan Sydney, who can get to Prince Alfred Hospital via ambulance within 15 minutes,” he says. “You can’t fix that disparity. You just have to do what you can to minimise it.”

Take charge of your health. Whether you’re living with a heart condition or supporting a loved one, understanding your care options is important. Visit Hearts4heart’s How connected cardiac care supports heart health page for practical information, patient resources and support.

This content is general in nature and is not a substitute for professional medical advice, diagnosis or treatment. Always consult your GP or healthcare specialist regarding any health concerns or symptoms. In a medical emergency, call 000 immediately.

¹Yang, S. et al. (2022) ‘Clinical utility of remote monitoring for patients with cardiac implantable electrical devices’, Journal of Interventional Cardiac Electrophysiology, 66(4), pp. 961–969. doi:10.1007/s10840-022-01406-7.

²Medtronic Data on File