Utilization and Clinical Feasibility of a Handheld Remote Electrocardiography Recording Device in Cardiac Arrhythmias and Atrial Fibrillation: A Pilot Study

Abstract

Background: Remote cardiac rhythm monitoring and diagnosis has been well incorporated in the telehealth service model. The prevalence and incidence of abnormal ventricular beats, based on utilizing a symptom-driven portable remote electrocardiography (ECG) device, remains less well explored. Methods: We studied 339 consecutive study participants, which included 192 individuals from outpatient clinics who were enrolled via a symptom-driven protocol; 147 participated in a heart rhythm screening program. All participants underwent 24-hour data transfer using a handheld portable electrocardiogram (ECG) device (DailyCare Biomedical Inc., Taoyuan City, Taiwan) with automatic ECG wavelet data extraction software (InstantCheck, version 4.0; DailyCare Biomedical Inc., Taoyuan City, Taiwan). Results: Among 1152 data transferred (98.4% success rate), we noticed 32.5% of the study participants had evidence of cardiac arrhythmias with permanent or paroxysmal atrial fibrillation (AF) constituting 50.9% of arrhythmias. Individuals with a history of heart failure (odds ratio [OR], 3.37; 95% confidence interval [CI], 1.69–6.74), diabetes (OR, 3.03; 95% CI, 1.67–5.49), and cardiovascular disease (OR, 3.71; 95% CI, 2.05–6.7) had a higher AF risk. Both populations had an age-related increase in AF, even in multivariate models (OR, 1.72; 95% CI, 1.31–2.24 per +decade). Conclusion: The handheld ECG device shows clinical feasibility with high rate for AF detection with a similar trend toward a higher prevalence with aging from different settings. These data suggested that portable ECG device via remote care system may aid in clinical diagnosis, therapeutic interventions, or patient referral for cardiac arrhythmias.

Keywords

• arrhythmias
• atrial fibrillation
• electrocardiography device
• handheld
• telehealth service