The digital revolution in cardiovascular care should not escape scientific scrutiny: a discussion paper

Abstract

Background: The rapid evolution and adoption of wearable technologies shows both promise and complexity for contemporary nursing practice. Aim: To critically examine the integration of digital health innovation, particularly wearable and implantable cardiac monitoring devices, within acute care. Design: Discursive paper. Summary: While these technologies offer opportunities for continuous, real-time monitoring and early detection of arrhythmias such as atrial fibrillation (AF), translation and adoption are hindered by evidence, regulatory challenges, and limited co-design with clinicians and consumers. Nurses are well-positioned to lead the translation and adoption of these technologies into practice, yet must navigate issues of data accuracy, cybersecurity, and workflow disruption. Drawing on recent evidence and clinical guidelines, the potential of wearables to reduce stroke burden through improved AF detection is explored and emerging smart-technologies capable of generating holistic ‘digital phenotypes’ featured. The ethical and clinical implications of shifting routine nursing activities, such as routine vital sign monitoring, towards automated systems are reviewed in relation to the merits of recalibrating nursing care to focus on high-value care activities. This discussion highlights the need for new and agile research methodologies, cross-disciplinary partnerships, and nurse-led innovation to ensure that wearable technologies are safe, effective, and tailored to patient needs. The paper provides a call to action for a proactive nursing agenda that leads in digital transformation, whilst upholding the principles of person-centred care.