Cardiovascular disease is one of the main causes of morbidity and mortality worldwide. Despite the availability of highly effective treatments, the contemporary burden of disease remains huge. Digital health interventions hold promise to improve further the quality and experience of cardiovascular care. This position paper provides a brief overview of currently existing digital health applications in different cardiovascular disease settings. It provides the reader with the most relevant challenges for their large-scale deployment in Europe. The potential role of different stakeholders and related challenges are identified, and the key points suggestions on how to proceed are given. This position paper was developed by the European Society of Cardiology (ESC) e-Cardiology working group, in close collaboration with the ESC Digital

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The fractal scaling properties of the heartbeat time series are studied in different controlled ergometric regimes using both the improved Hurst rescaled range (R/S) analysis and the detrended fluctuation analysis (DFA). The long-time "memory effect" quantified by the value of the Hurst exponent H>0.5 is found to increase during progressive physical activity in healthy subjects, in contrast to those having stable angina pectoris, where it decreases. The results are also supported by the detrended fluctuation analysis. We argue that this finding may be used as a useful new diagnostic parameter for short heartbeat time series.

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