Cutting edge smartphone technology has proved five times more effective at diagnosing heart rhythm problems than standard tests, as well as nearly £1,000 cheaper per diagnosis, in a trial part-funded by the British Heart Foundation.
A smartphone-based electrocardiogram (ECG) recorder called the the AliveCor® KardiaMobile has enabled doctors in 15 A&E departments across the UK to diagnose the cause of the palpitations in more than 40% more patients than standard tests alone.
Researchers at the University of Edinburgh and NHS Lothian carried out the first randomised control trial of the device, involving 243 patients presenting with heart palpitations or near blackout. Each year in the UK, there are hundreds of thousands of visits to emergency departments by people experiencing palpitations, where the heartbeat suddenly becomes more noticeable, or pre-syncope, when a person feels faint.
Both palpitations and pre-syncope are usually harmless and can be caused by stress, strenuous exercise, caffeine or certain medications. But they can also be caused by serious underlying heart rhythm disorders such as atrial fibrillation, which can lead to a stroke, and diagnosing the exact underlying cause in A&E is often difficult.
An ECG is used to detect the heart rhythm and diagnose the patient, but by the time he or she has made it to A&E, they have often recovered and their ECG is normal. In the trial, 124 patients were given the KardiaMobile device to take home, while the other 116 patients underwent standard tests and follow-up.
The KardiaMobile is attached to the back of a smartphone or tablet and is activated by the patient when they experience a palpitation. The ECG result from the device can then be taken or sent electronically to a doctor to help diagnose the problem.
After 90 days, ECGs taken by the device allowed doctors to diagnose 56% of patients in an average of 9.5 days. In comparison, just 10% of patients given standard care were diagnosed, with an average diagnosis time of 43 days. In addition, the KardiaMobile cut the cost of a diagnosis by an average of £921, from £1,395 to £474, due to the relative higher cost of 24-hour, 48-hour or seven-day Holter monitoring used in the standard care group.
BHF Associate Medical Director Professor Jeremy Pearson said: “Palpitations are normally a temporary, but noticeable, rapid or irregular fluttering of the heartbeat. These need to be investigated by a doctor, either to reassure people experiencing them that they are harmless or to diagnose and treat any underlying heart problem.
“By taking advantage of the tech that we carry around in our pockets every day, this cutting-edge device makes sure that it’s easy for people experiencing palpitations to directly record their heartbeat. They can then relay the information rapidly to a doctor and improve their diagnosis. This device could spare people from further anxiety, save the NHS money and, more importantly, save lives.”
Lead author Dr Matthew Reed, from Edinburgh Royal Infirmary, said: "We've shown that this device is an easy, cheap way to diagnose heart rhythm problems which usually see people attending emergency departments several times before they're diagnosed.
"For those with harmless palpitations this device can quickly give reassurance, whilst for those with serious underlying heart conditions it can act as a lifesaver. We are now calling for this technology to be rolled out in emergency departments across the country."
