WHOOP positioning as a clinical tool for Heart Failure management

Whoop for heart failure management

Researchers at the Milton Hersey Medical center are currently evaluating if WHOOP as a device can be used as a clinical tool for heart failure management.

Among the various health-based trials being conducted by this medical center using WHOOP, this new study was launched in July 2020 with the primary objective to study heart failure (HF) patients to assess better HF disease state, which can aid in the management and improve outcomes.

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The new clinical trial study plans on achieving the following key aims:

  1. Measure HR and RR at rest and during a daily activity using the WHOOP 3.0 device
  2. Correlate HR and RR response to activity to New York Heart Association (NYHA) classification and 90-day HF hospitalization rate. 
  3. Identify additional predictors of the NYHA class. And HF hospitalization rate for algorithm development to use the WHOOP device as a clinical tool for HF management.

What is the New York Heart Association Classification?

The New York Heart Association (NYHA) Classification provides a simple way of classifying the extent of heart failure. It classifies patients into one of four categories based on their physical activity limitations; the limitations/symptoms are regarding normal breathing and varying degrees in shortness of breath and or angina pain.

  1. Class I – No symptoms and no limitation in ordinary physical activity, e.g., shortness of breath when walking, climbing stairs, etc.
  2. Class II – Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity.
  3. Class III – Marked limitation inactivity due to symptoms, even during less-than-ordinary activity, e.g., walking short distances (20—100 m). Comfortable only at rest.
  4. Class IV – Severe limitations. Experiences symptoms even while at rest—mostly bedbound patients.

Significance of Resting Heart Rate

According to Mayo Clinic, adults’ normal resting heart rate ranges from 60 to 100 beats per minute.

Generally, a lower heart rate at rest implies more efficient heart function and better cardiovascular fitness. For example, a well-trained athlete might have a normal resting heart rate closer to 40 beats per minute.

Research has shown that a resting heart rate near the top of the 60 to 100 range can increase your risk for cardiovascular disease and even early death.

For example, a 2013 study in the journal Heart tracked the cardiovascular health of about 3,000 men for 16 years and found that a high resting heart rate was linked with lower physical fitness and higher blood pressure, body weight, and levels of circulating blood fats. 

The study researchers also discovered that the higher a person’s resting heart rate, the greater the risk of premature death. 

Specifically, an RHR between 81 and 90 doubled the chance of death, while an RHR higher than 90 tripled it.

One reliable way to lower your resting heart rate is to exercise. Even small amounts of exercise can make a change, according to doctors.

Among patients readmitted within 90 days after index hospitalization discharge, ≈60% of readmission events occurred beyond 30 days. Patients readmitted within 90 days had a higher risk of long‐term mortality, regardless of the temporal proximity of readmission to the index hospitalization.  

Whoop Respiratory rate feature

WHOOP Study process for Heart Failure management

This study will monitor 25 participants. It will focus on patients who have not been hospitalized in the past 1 year, but have a heart failure diagnosis, will be enrolled during routine outpatient care to wear the WHOOP device for 90 days.

The daily average heart rate (HR) and the average resting rate (RR) will be continuously measured for these participants.

RELATED: Whoop working towards features to monitor IBD Flareups

A 6-minute walk test will be used to assess exercise tolerance and hypoxia with ambulation, among other outcome measures.

Decreased exercise tolerance and increased hypoxia with walking are expected to be associated with worse NYHA HF class, increases in average HR and RR, HR and RR increases with activity, and increased HF hospitalization rate.

The 6-minute walk test is becoming a major tool for applications focussed on remote monitoring. It is no surprise that Apple decided to include this in its new mobility metrics in watchOS 7.

This new study expected to start in September 2020 and complete by early 2021. 

It is becoming clear that WHOOP’s access to continuous heart rate monitoring and other recovery metrics is bound to open new doors for more personalized disease monitoring and management beyond front-line detection use cases.


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Sudz Niel Kar
I am a technologist with years of experience with Apple and wearOS products, have a BS in Computer Science and an MBA specializing in emerging tech, and owned the popular site AppleToolBox. In my day job, I advise Fortune 500 companies with their digital transformation strategies and also consult with numerous digital health startups in an advisory capacity. I'm VERY interested in exploring the digital health and fitness-tech evolution and keeping a close eye on patents, FDA approvals, strategic partnerships, and developments happening in the wearables and digital health sector. When I'm not writing or presenting, I run with my Apple Watch Ultra or Samsung Galaxy Watch and closely monitor my HRV and other recovery metrics.


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