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Smartphone-based ECG Monitors for the Diagnosis of Heart Rhythm Disorders
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Smartphone-based ECG Monitors for the Diagnosis of Heart Rhythm Disorders

Associate Professor Saurabh Kumar, Institution: University of Sydney

2019 Vanguard Grant

Years funded: 2020-2021


Heart rhythm disorders (arrhythmias) are a major contributor emergency department hospitalisations/clinic visits contributing to significant health costs. Some arrhythmias (eg atrial fibrillation) carry serious prognostic implications such as heightened risk of stroke/dementia/heart failure; others such as ventricular tachycardia lead to sudden death/cardiac arrest. Timely and accurate diagnosis is critical.

A major challenge is arrhythmia diagnosis, which can be elusive due to their paroxysmal non-sustained nature, requiring multiple attempts at 'capture' via electrocardiograph (ECG) or ambulatory ECG (Holter monitoring). 24/7 accessibility to such investigations is also limited, thus symptom-rhythm correlation is often not feasible, leading to repeated investigations, before a diagnosis is finally made, resulting in significant patient morbidity and health care costs.

A commercially available, smart-phone based ECG recorder (Kardiamobile or KardiaBand from Alivecor Inc) can reconstruct an ECG from the patient's pulse waveform. Isolated case reports and small studies have suggested their utility in aiding diagnosis of patients with undiagnosed palpitations. Other studies have shown their utility in community screening for asymptomatic high risk arrhythmias such as atrial fibrillation potentially allowing early primary prevention of stroke with anticoagulation.

However, the accuracy of these devices for detecting arrhythmias is not known. We will examine the utility of these devices in the detection and management of arrhythmias by examining if (a) such devices accurately detect common cardiac arrhythmias against a gold standard of arrhythmia confirmation in a cardiac electrophysiology lab; (b) such devices increase the yield for detection of paroxysmal arrhythmias above traditional ambulatory monitoring. By empowering the patient with a self-funded rhythm monitor, we anticipate significant reduction in time to diagnosis and cost saving to the health care system.

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