Comparison of QT Interval Readings in Normal Sinus Rhythm Between a Smartphone Heart Monitor and a 12‐Lead ECG for Healthy Volunteers and Inpatients Receiving Sotalol or Dofetilide

Garabelli, Paul; Stavrakis, Stavros; Albert, Brandee; Koomson, Edward; Parwani, Purvi; Chohan, B S Jawad; Smith, Landgrave; Albert, David E.; Rong-sheng, Xie; Xie, Qiying; M.D., F.H.R.S. Dwight Reynolds; Po, Foss

doi:10.1111/jce.12976

Cited by 101 publications

(97 citation statements)

References 23 publications

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“…4. The US Food and Drugs Administration (FDA) has approved the use of KardiaMobile 6 L (AliveCore) to monitor the QTc duration in COVID-19 patients receiving QTprolonging drugs [16]. This avoids exposure of ECG technicians to affected patients and unnecessary use of PPE.…”

Section: Patients With a Baseline Qtc > 500 Ms And Those With Amentioning

confidence: 99%

Recommendations for the organization of electrophysiology and cardiac pacing services during the COVID-19 pandemic

Sáenz

Miranda²,

Speranza

et al. 2020

J Interv Card Electrophysiol

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COVID-19 is a rapidly evolving public health emergency that has largely impacted the provision of healthcare services around the world. The challenge for electrophysiology teams is double; on one side preventing disease spread by limiting all nonessential face-to-face interactions, but at the same time ensuring continued care for patients who need it. These guidelines contain recommendations regarding triaging in order to define what procedures, device checks and clinic visits can be postponed during the pandemic. We also discuss best practices to protect patients and healthcare workers and provide guidance for the management of COVID-19 patients with arrhythmic conditions.

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Section: Patients With a Baseline Qtc > 500 Ms And Those With Amentioning

confidence: 99%

Recommendations for the organization of electrophysiology and cardiac pacing services during the COVID-19 pandemic

Sáenz

Miranda²,

Speranza

et al. 2020

J Interv Card Electrophysiol

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“…Noteworthy is that patients with a pacemaker present were significantly less likely to have a dose adjustment, and more likely to successfully initiate sotalol than those without, perhaps due to less bradycardia, which was a key reason for failure of initiation. Given the continued advances in remote monitoring of cardiac implantable devices 27, 28 , as well as development of wearable/portable devices for measuring QT interval 29, 30 , it seems that our findings support the possibility that these patients could undergo outpatient initiation of sotalol, although more work is clearly needed.…”

Section: Discussionmentioning

confidence: 63%

Multicenter Analysis of Dosing Protocols for Sotalol Initiation

Biswas

Levy

Weber

et al. 2019

Preprint

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Sotalol is a Vaughan-Williams Class III antiarrhythmic medication that is commonly used in the management of both atrial and ventricular arrhythmias. Like others in this class, sotalol carries a risk of the potentially lethal arrhythmia torsade de pointes due to its effect of prolonging the QT interval on ECG. For this reason, many centers admit patients for telemetry monitoring during the initial 2-3 days of dosing. However, despite its widespread use, little information is available about the dosing protocols used during this initiation process. In this multicenter investigation, we examine the characteristics of various dose protocols in 213 patients who initiated sotalol over a 4-year period. Of these patients, over 90% were able to successfully complete the dosing regimen (i.e., were discharged on the medication). Significant bradycardia, excessive QT prolongation, and ineffectiveness were the main reasons for failed completion.We found that any dose adjustment was one of the strongest univariate predictors of successful initiation (OR 6.6, 95%CI 1.3 -32.7, p = 0.021), while initial dose, indication, and resting heart rate or QT interval on baseline ECG did not predict successful initiation. Several predictors of any dose adjustment were identified, and included diabetes, hypertension, presence of pacemaker, heart failure diagnosis, and depressed LV ejection fraction. Using marginal structural models (i.e., inverse probability weighting based on probability of a dose adjustment), we verified that these factors also predicted successful initiation via preventing any dose adjustment, and suggests that consideration of these factors may result in higher likelihood of successful initiation in future investigations. In conclusion, we found that the majority of patients admitted for sotalol initiation are successfully discharged on the medication, often without a single adjustment in the dose. Our findings suggest that several factors predicting lack of dose adjustment could be used clinically to identify patients who could potentially undergo outpatient initiation, although prospective studies are needed to verify this approach. BackgroundSotalol is a Vaughan-Williams (VW) Class III antiarrhythmic agent that is used in the treatment of atrial 1-3 and ventricular arrhythmias 4-8 . Composed of a racemic mix of two isomers, the d and l isomers of sotalol work together to prolong repolarization (d-and l-isomer) along with nonselective beta-blocking properties (l-isomer). This property is significant as use of isolated d-Sotalol was found to be associated with increased mortality in patients with heart failure in the SWORD study 9 , while use of the racemic mixture is generally considered to be safer in this population. Like other VW Class III agents, sotalol displays reverse use dependence properties, in which heart rate and the QT interval are inversely related such that at lower heart rates, the QT interval prolongs 10 . At doses between 160 and 640 mg/day, sotalol increases QT interval by 40 to 100 ms 11 . In a co...

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“…The utility of the device was demonstrated in a community-based setting for detection of atrial fibrillation 12 and for detection of QT interval. 13…”

Section: Alivecor Kardiamentioning

confidence: 99%

Portable out‐of‐hospital electrocardiography: A review of current technologies

Bansal

Joshi

2018

Journal of Arrhythmia

147

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BackgroundAvailability of portable and home‐based electrocardiography (ECG) is an important medical innovation, which has a potential to transform medical care. We performed this review to understand the current state of out‐of‐hospital portable ECG technologies with respect to their scope, ease of use, data transmission capabilities, and diagnostic accuracy.MethodsWe conducted PubMed and Internet searches for “handheld” or “wearable” or “patch” electrocardiography devices to enlist available technologies. We also searched PubMed with names of individual devices to obtain additional citations. We classified available devices as a “single limb lead ECG recording devices” and chest‐lead “ECG recording devices.” If a device used more than three electrodes, it was defined as a conventional electrocardiography or Holter machine and was excluded from this review.ResultsWe identified a total of 15 devices. Overall, only six of these devices (five single lead and one chest lead) featured in published medical literature as identified from PubMed search. A total of 13 citations were available for the single limb lead ECG recording devices and 6 citations for the chest‐lead ECG recording devices.ConclusionsDespite the increase in number of such devices, published biomedical literature regarding their diagnostic accuracy, reproducibility, or utility is scant.

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Comparison of QT Interval Readings in Normal Sinus Rhythm Between a Smartphone Heart Monitor and a 12‐Lead ECG for Healthy Volunteers and Inpatients Receiving Sotalol or Dofetilide

Cited by 101 publications

References 23 publications

Recommendations for the organization of electrophysiology and cardiac pacing services during the COVID-19 pandemic

Recommendations for the organization of electrophysiology and cardiac pacing services during the COVID-19 pandemic

Multicenter Analysis of Dosing Protocols for Sotalol Initiation

Portable out‐of‐hospital electrocardiography: A review of current technologies

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