New Real‐Time Loop Recorder Diagnosis of Symptomatic Arrhythmia Via Telemedicine

Abstract

Background:One disadvantage of current loop recorders is the long interval between recording an electrocardiogram (ECG), establishing a diagnosis, and taking appropriate medical measures. The Cardio R loop recorder transmits cardiac recordings by cellular communication at the push of a button. Users can concomitantly relay symptoms, thereby providing a symptom/cardio‐rhythm correlation.Hypothesis:The Cardio R is capable of early detection of cardio‐electrical events that could account for patients' symptoms.Methods:This observational study was designed to evaluate patients who were referred from community physicians/cardiologists for evaluation of various cardiac symptoms that were not observed by regular office ECGs or traditional 24‐hour Holter cardiac monitoring. Transmitted recordings were instantly displayed on a monitor for immediate diagnosis by the on‐duty medical team at SHL‐Telemedicine's call center. Abnormal tracings, especially when accompanied by symptoms selected from the prepared list, enabled the staff to instruct the subscriber, notify their physician, and/or dispatch a mobile intensive care unit to the scene.Results:Between January 2009 and August 2010, there were 17 622 ECG transmissions received from 604 patients (age range, 10–95 years) who completed a 1‐month trial with the Cardio R device. Palpitation, presyncope, and chest pain were the leading complaints. A disturbance in rhythm that could account for symptoms occurred during recording in 49% cases and was displayed within 7 minutes in 93% of them. No longer than 2 days elapsed from recording onset to diagnosis.Conclusions:The Cardio R device enables prompt ECG confirmation/exclusion of a probable arrhythmic cause of symptoms, enabling rapid intervention for cardiac‐relevant complaints. © 2011 Wiley Periodicals, Inc.Dr. Arie Roth is a medical consultant for SHL‐Telemedicine.The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Emissão de laudos eletrocardiográficos a distância: experiência da rede catarinense de telemedicina

“…; they can also assist in the diagnosis of outpatients with arrhythmia, since they enable longer observation periods 12 . In ambulances, they may assist the monitoring and decision making in severely ill patients 13,14 and provide excellent service to patients with severe decompensated heart disease, even when the procedure is performed by paramedics or other health professionals 15 .…”

Long-term event-Holter monitoring in low-populated areas as a valuable diagnostic tool in the detection of arrhythmia

“…allows instant transfer of data to a remotely located clinical center. Acute care centers working in 24-hour mode are able to continually analyze reported symptoms, obtained recordings, and to provide adequate support to the patients (12). Disadvantages of eventHolter include the need to constantly maintain connection of the device to the chest via electrodes, which may result in local irritation of the skin and adversely affect the compliance of the patients (13).…”

Remote Patient Monitoring and Telemedicine in Neonatal and Pediatric Settings: Scoping Literature Review (Preprint)

“…HOME MONITORING OF CARDIOVASCULAR IMPLANTABLE DEVICES Cardiovascular implantable devices are being used increasingly in the pediatric population as a method of long-term remote patient monitoring [11]. A variety of research studies have examined the role of remote patient monitoring with implantable devices in decreasing incidence of adverse cardiac events [11][12][13][14]. In these studies, patients with newly implanted cardiac devices were followed either prospectively or retrospectively via remote patient monitoring and compared to patients with the same devices who were monitored traditionally.…”

“…At the cardiac care center, data was analyzed by a cardiac physician or care nurse and contact to patients and families was initiated via internet, telephone, or text messaging depending on results, typically in the form of an electrocardiograph (ECG). In two cases, patients were also able to report symptoms and record specific suspected cardiac events to be sent to the cardiac care team [13][14].…”

“…Additionally, 87 percent of patients and families rated the remote monitoring to be "very easy to perform" in the study. Leshem-Rubinow et al [13] achieved a median time between data transmission and viewing ECG data of 7 minutes, interpretation of the ECG was accomplished by trained cardiac staff within 5 hours, and diagnosis of cardiac events averaged at 16 hours after transmission of data. Malloy et al [11] found that remote patient monitoring decreased the average number of days that patients went without physician contact, potentially decreasing adverse events.…”