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Mobile heart monitoring: advantages and limitations

During the first wave of the pandemic, when hydroxychloroquine was still thought to be an effective treatment for hospitalized patients with COVID-1 9( subsequent studies have shown otherwise ), some U.S. hospices used personal electrocardiogram( ECG) maneuvers to monitor these patients for drug-induced QT interval prolongation to conserve personal protective paraphernalium and telemetry observes. Such maneuvers were already being used by cases with known cardiac preconditions to monitor their feeling lilts in out-of-office defines.

As I discussed in a previous post, wearable machines such as the Apple Watch are also being studied to spy atrial fibrillation in asymptomatic primary health care patients. In a 2019 study of more than 400,000 U.S. Apple Watch wearers with no self-reported history of atrial fibrillation, about 1 in 200 individuals received an erratic pulsate notification and were scheduled to be held in a telemedicine visit with a clinician to approve study fitnes and triage those with urgent evidences to the emergency department. Participates without urgent evidences were mailed an ECG patch to wear for up to 7 days and then mail back to the study center.

Of the 450 participants who returned an ECG patch, 34% were confirmed to have atrial fibrillation, with a higher diagnostic yield in persons senility 65 years or older. Of the 86 patients whose watches engendered irregular heartbeat notifications when they were wearing the ECG patch, the positive predictive importance for atrial fibrillation was 84%. In a inspect accomplished at 90 epoches by patients who received an irregular pulsing notification, 28% reported being prescribed a brand-new prescription, 33% were referred to a specialist, and 36% were recommended to have additional testing.

In the November 1 issue of American Family Physician, Dr. Madhavi Singh and peers reviewed the diagnostic assessment the specific characteristics of KardiaMobile, a $99 single-lead device that connects wirelessly to a smartphone app to generate an ECG tracing with automated reading. In studies of patients with known or believed arrhythmias, KardiaMobile had higher than 90% sensibility and specificity for atrial fibrillation or atrial flit compared to a standard 12 -lead ECG. However , no studies have compared its accuracy with a Holter or occurrence check, and impacts on patient outcomes are uncertain, particularly in populations at low-spirited hazard for arrhythmias.( In 2018, the U.S. Preventive Services Task Force found insufficient evidence to assess the balance of benefits and harms of screening for atrial fibrillation, which has several potential downsides .) The columnists concluded( and I agree) that similar to the Apple Watch, “further studies are needed before KardiaMobile can be recommended for use in apparently healthy patients.”

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This post first is available on the AFP Community Blog.

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