Wearables for Telemonitoring in ATTR-Amyloidosis: Current Perspectives

Area of Science:

• Cardiovascular Medicine
• Digital Health
• Biomarker Discovery

Background:

• Transthyretin amyloidosis (ATTR) is a progressive multisystem disease impacting the cardiovascular and neurological systems.
• ATTR is characterized by arrhythmias, conduction issues, hemodynamic instability, autonomic dysfunction, and gait abnormalities.
• These multifaceted symptoms suggest ATTR is a suitable candidate for multimodal wearable monitoring.

Purpose of the Study:

• To review current knowledge on wearable sensor applications in amyloidosis, using ATTR as a model.
• To assess the feasibility of using digital biomarkers from related conditions for ATTR.
• To identify challenges in developing and implementing wearable monitoring for ATTR.

Main Methods:

• Literature review of current studies on wearable monitoring in ATTR and related cardiovascular/neurological conditions.
• Evaluation of signal-based biomarker extraction from electrocardiographic, photoplethysmographic, and inertial sensor data.
• Analysis of methodological and implementation challenges for wearable technology in ATTR.

Main Results:

• ATTR-specific data are limited, primarily from small studies on rhythm monitoring and functional assessments.
• Metrics like atrial fibrillation burden, activity patterns, gait variability, and heart rate variability show potential.
• ATTR's structural changes and high arrhythmia burden may complicate conventional digital biomarker interpretation, requiring disease-specific approaches.

Conclusions:

• Wearable monitoring in ATTR is technically feasible and biologically plausible but currently investigational.
• Standardized, phenotype-stratified studies are essential to link wearable data to clinical outcomes.
• Routine integration into care pathways requires further validation of wearable-derived characteristics.