Smartphone ECG Monitoring System Helps Lower Emergency Room and Clinic Visits in Post-Atrial Fibrillation Ablation Patients

Abstract

Aim: To evaluate the effectiveness of using a smartphone-based electrocardiography (ECG) monitoring device (ECG Check) on the frequency of clinic or emergency room visits in patients who underwent ablation of atrial fibrillation (AF).

Methods: Two groups of patients were identified and compared: The conventional monitoring group (CM group) included patients who were prescribed conventional event monitoring or Holter monitoring systems. The ECG Check group (EC group) included patients who were prescribed the ECG Check device for continuous monitoring in addition to conventional event monitoring. The primary outcome was the number of patient visits to clinic or emergency room. The feasibility, accuracy, and detection rate of mobile ECG Check were also evaluated.

Results: Ninety patients were studied (mean age: 66.2 ± 11 years, 64 males, mean CHA2DS2-VASc score: 2.6 ± 2). In the EC group, forty-five patients sent an average of 52.8 ± 6 ECG records for either routine monitoring or symptoms of potential AF during the follow-up period. The rhythm strips identified sinus rhythm (84.7%), sinus tachycardia (8.4%), AF (4.2%), and atrial flutter (0.9%). Forty-two EC transmissions (1.8%) were uninterpretable. Six patients (13%) in the EC group were seen in the clinic or emergency room over a 100-day study period versus 16 (33%) in the standard care arm (P value < 0.001).

Conclusions: Use of smartphone-based ECG monitoring led to a significant reduction in AF-related visits to clinic or emergency department in the postablation period.

Keywords: Mobile ECG; atrial ablation; atrial fibrillation.

Conflict of interest statement

Declaration of Conflicting Interest:Dr N.F.M. has received consulting fees from Abbott, Biotronik, Wavelet Health, Cardiac Design, Medtronic, Preventice, Vytronus, Biosense Webster, Marrek, Inc., and Boston Scientific; has received research funding from Abbott, Boston Scientific, GE Healthcare, Siemens, Biotronik, Vytronus, and Biosense Webster; has an ownership interest in Marrek, Inc., and Cardiac Designs; and has conducted contracted research with Biosense Webster, Medtronic, St. Jude Medical, and Boston Scientific. Dr M.G.C. has received research funding from Wavelet Health, Biotronik, Medtronic, and Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

© The Author(s) 2020.

Figures

Figure 1.

Transmission of ECG Check device ECG recordings. ECG indicates electrocardiography.

Figure 2.

ECG Check clinical algorithm. AAD indicates antiarrhythmic drug; AF, atrial fibrillation; CP, chest pain; DCCV, DC cardioversion; ED, emergency department.

Figure 3.

Patient-provider communication to manage AF episode detected on ECG Check device. AF indicates atrial fibrillation; ECG, electrocardiography.

Figure 4.

Total ECG recordings transmitted via ECG Check devices over 100 days. AF indicates atrial fibrillation; ECG, electrocardiography.

Figure 5.

Number of AF-related outpatient department (OPD) and ED visits for EC group and conventional group. AF indicates atrial fibrillation; CM, conventional monitoring; EC, ECG Check; ECG, electrocardiography; ED, emergency department.