Comparison of 2 ambulatory patch ECG monitors: The benefit of the P-wave and signal clarity

Rho, Robert W.; Vossler, Mark; Blancher, Susan; Poole, Jeanne E.

doi:10.1016/j.ahj.2018.03.022

Cited by 19 publications

(14 citation statements)

References 11 publications

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“…AF is, in many ways, an ideal target for biosensors. Numerous ECG sensors focus on detecting rapid and irregularly irregular QRS complexes in AF, but other metrics of rapid and irregular atrial rate and irregular beat-to-beat waveforms might increase diagnostic specificity 27 . AF can also cause beat-to-beat changes in perfusion and haemodynamics that might allow detection from non-electrical biosignals.…”

Section: Ecg Monitoringmentioning

confidence: 99%

“…At present, unclassifiable tracings are common among all ECG monitoring devices, which is likely to improve with technological advances 35 . Some systems have increased signal fidelity, such as the KardiaMobile six-lead device (Alivecor) or the CAM device (BardyDx), which might reduce noise and improve P-wave discernment 27 . Patients are increasingly opting for FDA-approved consumer devices, which increases the urgency to extend guidelines to adopt such technologies when appropriate 36 .…”

Section: Ecg Monitoringmentioning

confidence: 99%

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Integration of novel monitoring devices with machine learning technology for scalable cardiovascular management

et al. 2020

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Ambulatory monitoring is increasingly important for cardiovascular care but is often limited by the unpredictability of cardiovascular events, the intermittent nature of ambulatory monitors and the variable clinical significance of recorded data in patients. Technological advances in computing have led to the introduction of novel physiological biosignals that can increase the frequency at which abnormalities in cardiovascular parameters can be detected, making expert-level, automated diagnosis a reality. However, use of these biosignals for diagnosis also raises numerous concerns related to accuracy and actionability within clinical guidelines, in addition to medico-legal and ethical issues. Analytical methods such as machine learning can potentially increase the accuracy and improve the actionability of device-based diagnoses. Coupled with interoperability of data to widen access to all stakeholders, seamless connectivity (an internet of things) and maintenance of anonymity, this approach could ultimately facilitate near-real-time diagnosis and therapy. T he se tools are increasingly recognized by regulatory a g e n c ies a n d p r o f e s s ional m e d ic al s oc ie ti es, but several technical and ethical issues remain. In this Review, we describe the current state of cardiovascular monitoring along the continuum from biosignal acquisition to the identification of novel biosensors and the development of analytical techniques and ultimately to regulatory and ethical issues. Furthermore, we outline new paradigms for cardiovascular monitoring.

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Section: Ecg Monitoringmentioning

confidence: 99%

Section: Ecg Monitoringmentioning

confidence: 99%

Integration of novel monitoring devices with machine learning technology for scalable cardiovascular management

et al. 2020

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“…The CAM patch utilizes a novel circuit design with compressed algorithms to process P wave signal, and placing the patch over the sternum creates a lead similar to aVF, resulting in the high sensitivity of the P-wave. 6, 7 Traditional continuous telemetry provides a three-channel rhythm strip; however, the P wave is rarely displayed clearly.5 This is especially apparent in pediatrics, where movement artifact frequently degrades the quality of Holter recordings. 5, 7 We were pleased to find less noise on our tracings despite the CAM patches higher P wave sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…6, 7 Traditional continuous telemetry provides a three-channel rhythm strip; however, the P wave is rarely displayed clearly.5 This is especially apparent in pediatrics, where movement artifact frequently degrades the quality of Holter recordings. 5, 7 We were pleased to find less noise on our tracings despite the CAM patches higher P wave sensitivity. In our practice, the accurate identification of multifocal atrial tachycardia and the differentiation between atrial tachycardia with aberrancy and ventricular tachycardia resulted in optimizing medical therapy and cessation of the arrhythmia.…”

Section: Discussionmentioning

confidence: 99%

“…Cost effective and accessible ambulatory electrocardiogram (ECG) monitors have become an essential diagnostic tool used in the assessment and management of arrhythmias, with obvious indications for pediatric patients.6 A recent adult study found the Carnation Ambulatory Monitor (CAM) patch by Bardy Diagnostics Inc. (Seattle, WA) to have higher rhythm specificity over other ambulatory monitors, identifying more episodes of atrial tachycardia, atrial flutter, and non-sustained ventricular tachycardia. 7 We planned to assess our use of the CAM patch in small pediatric patients for the quality of tracings and impact on clinical decision making.…”

Section: Introductionmentioning

confidence: 99%

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P-wave Centric Ambulatory ECG Monitoring in Infants and Young Children

Romme

Nguyen

2020

Preprint

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Background: P-wave centric ambulatory ECG monitoring has emerged as an important tool aiding the diagnosis of arrhythmias. However, with no specific pediatric approved ambulatory monitors, efficacy and user experience with these devices in young infants have not been established. Objective: To evaluate tracings quality in children less than 10 kilograms who have been prescribed the P-wave centric Carnation Ambulatory Monitor (CAM) patch by Bardy Diagnostics Inc. Methods: We performed an observational, retrospective study on patients prescribed 48-hour ambulatory Holter monitoring. We aimed to detail our experience with using the CAM patch with a patient population smaller than the recommended weight set forth by Bardy Diagnostics Inc. All patients less than 10 kg who were prescribed a 48-hour CAM patch were included in this review. Additionally, 2 different monitor locations (over the sternum and horizontal over the left axilla) were assessed to address the optimal placement in small children less than 10 kg. Results: A total of 33 CAM reports from 25 patients, aged 0-15 months were included in the study. Mean patient age was 4.2 months ± 5.0 and mean weight was 5.3 kg ± 2.4. Twenty-Four percent of patients (8/33) had known congenital heart disease. Indications for monitoring included: tachyarrhythmia (15/33, 45%), bradycardia (6/33, 18%), ectopic rhythm (9/33, 27%), cardiac tumor (1/33, 1%), and prolonged QT interval (1/33, 1%). All CAM reports showed clear, identifiable P waves which were diagnostic and lead to changes in medical management for 30% of patients (i.e. medication adjustments or discharge from cardiology care). When comparing the P wave between a 12-lead ECG and the CAM patch, 77% of patients had the same or similar P wave morphology to lead aVF. We found the recommended, upright placement over the sternum performed better than the horizontal placement over the left axilla for small infants and children less than 10 kg. Conclusion: A P-wave centric Holter monitor is helpful in providing accurate diagnostics tracings even in infants and small children aiding in their clinical management.

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Strain‐Isolating Materials and Interfacial Physics for Soft Wearable Bioelectronics and Wireless, Motion Artifact‐Controlled Health Monitoring

Rodeheaver

Herbert

Kim

et al. 2021

Adv Funct Materials

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Recent developments of micro‐sensors and flexible electronics allow for the manufacturing of health monitoring devices, including electrocardiogram (ECG) detection systems for inpatient monitoring and ambulatory health diagnosis, by mounting the device on the chest. Although some commercial devices in reported articles show examples of a portable recording of ECG, they lose valuable data due to significant motion artifacts. Here, a new class of strain‐isolating materials, hybrid interfacial physics, and soft material packaging for a strain‐isolated, wearable soft bioelectronic system (SIS) is reported. The fundamental mechanism of sensor‐embedded strain isolation is defined through a combination of analytical and computational studies and validated by dynamic experiments. Comprehensive research of hard‐soft material integration and isolation mechanics provides critical design features to minimize motion artifacts that can occur during both mild and excessive daily activities. A wireless, fully integrated SIS that incorporates a breathable, perforated membrane can measure real‐time, continuous physiological data, including high‐quality ECG, heart rate, respiratory rate, and activities. In vivo demonstration with multiple subjects and simultaneous comparison with commercial devices captures the SIS's outstanding performance, offering real‐world, continuous monitoring of the critical physiological signals with no data loss over eight consecutive hours in daily life, even with exaggerated body movements.

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Comparison of 2 ambulatory patch ECG monitors: The benefit of the P-wave and signal clarity

Cited by 19 publications

References 11 publications

Integration of novel monitoring devices with machine learning technology for scalable cardiovascular management

Integration of novel monitoring devices with machine learning technology for scalable cardiovascular management

P-wave Centric Ambulatory ECG Monitoring in Infants and Young Children

Strain‐Isolating Materials and Interfacial Physics for Soft Wearable Bioelectronics and Wireless, Motion Artifact‐Controlled Health Monitoring

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