Key result
Smartphone ECG linked to ~4-fold greater tachyarrhythmia documentation vs conventional monitors in children.
Why the study?
The study was motivated by the need to evaluate the effectiveness and patient acceptability of a smartphone-based ECG recording system compared with standard cardiac event monitoring in children with palpitations without syncope.
Does a smartphone-based ECG recording system improve diagnostic yield and patient satisfaction compared to a standard cardiac event monitor in children with palpitations?
Cohort (n=180)
Does a smartphone-based ECG recording system improve diagnostic yield and patient satisfaction compared to a standard cardiac event monitor in children with palpitations?
A smartphone-based ECG monitor significantly increases the diagnostic yield of tachyarrhythmias and patient satisfaction in children with palpitations compared to conventional event monitors.
May support smartphone ECG use in pediatric palpitations; leaves open confirmation of superiority in randomized trials.
BACKGROUND: The AliveCor (Kardia) monitor attaches to a smartphone and allows a single-lead ECG to be recorded during symptoms. In 2016, we introduced the use of this smartphone device for investigating palpitations, without syncope, in children. The aim of our study was to review our experience with the smartphone device, comparing it with our previous standard conventional approach to cardiac event monitoring using the Cardiocall monitor, which uses skin electrodes and is given for a finite period. METHODS: Over a period of 24 months, 80 smartphone monitors were issued and compared with the most recent 100 conventional event monitors. The number of ECG recordings received, arrhythmias documented, quality of ECG recordings and patient satisfaction were evaluated. RESULTS: Median patient age was 11 years in the smartphone monitor group compared with 10 years in the conventional group. Seventy-nine of 80 (98%) patients with a smartphone monitor sent an ECG recorded during symptoms, compared with 62/100 (62%) from the conventional group. A total of 836 ECG recordings were sent from the smartphone monitors compared with 752 from the conventional group. Eight per cent of ECG recordings in each group were of inadequate quality for analysis. Twenty of 80 (25%) patients with a smartphone monitor had documented tachyarrhythmia compared with 6/100 (6%) patients with the conventional monitor (p<0.001). On comparison with the conventional approach, the smartphone monitor outperformed with respect to diagnostic yield and patient satisfaction. CONCLUSIONS: A smartphone-based event monitor allows simple, effective, long-term ECG event monitoring in children that is highly acceptable to the patient and parent.
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Macinnes et al. (2018) conducted a cohort in Palpitations without syncope in children (n=180). Smartphone-based ECG recording system (AliveCor Kardia) vs. Standard conventional cardiac event monitor (Cardiocall) was evaluated on Documented tachyarrhythmia (p=<0.001). A smartphone-based ECG monitor significantly increased the documentation of tachyarrhythmia compared to a conventional event monitor in children with palpitations (25% vs 6%; p<0.001).
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