Transtelephonic electrocardiographic monitors for evaluation of children and adolescents with suspected arrhythmias

Comparison of a smartphone-based ECG recording system with a standard cardiac event monitor in the investigation of palpitations in children

“…The diagnostic quality of traces obtained was comparable to our previous standard approach to cardiac event monitoring. The majority of arrhythmias detected were SVT, this being the most common arrhythmia seen in the paediatric population 1. The arrhythmia yield was significantly higher in the smartphone monitor group, largely due to them being issued for the child to keep rather than for a finite period of time, although for those who sent recordings, the number of ECG traces submitted per patient was similar between the two groups.…”

“…Our standard approach to diagnosis has relied on cardiac event monitors with skin electrodes to record an ECG during symptoms 1. These are associated with a number of problems in children, including irritation of the skin by electrodes and failure to capture the ECG because of infrequent symptoms, coupled with relatively short duration of wearing the monitor or not wearing it when symptoms occur.…”

Diagnostic Yield of Patch Ambulatory Electrocardiogram Monitoring in Children (from a National Registry)

“…In a single-center study of symptomatic children with suspected arrhythmias, 15% of the 238 patients had SVT detected using patient-activated transtelephonic electrocardiographic event monitors. 17 In our study using the patch, 22.7% of all the children referred for suspected SVT were found to have SVT.…”

2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry

“…Conversely, sinus tachycardia is identified in nearly 50% of patients with the same symptoms (Dick, McFadden, Crowley, & Rosenthal, 1979;Fyfe, Holmes, Neubauer, & Feldt, 1984;Goldstein, Hesslein, & Dunnigan, 1990;Karpawich, Cavitt, & Sugalski, 1993). In one single-center experience of 495 pediatric patients, transtelephonic electrocardiographic event monitors (TTMs) yielded a useful diagnosis in 48% (Saarel et al, 2004). Conversely, >50% patients in this study failed to transmit a single, legible ECG while symptomatic, highlighting the limitation of patient-activated equipment in the pediatric population.…”