In-home patient screening to support atrial fibrillation patients done via a monitor called AliveCor and attached to a Wi-Fi enabled iPod can obtain electrocardiograms from the ambulatory patients and negate the need for frequent physician office visits.
The approach was recently studied by researchers, who incorporated 1,001 patients older than age 65—half participated with the mobile devices, while the other half served as comparative group. Participants who used the technology sent readings twice weekly over 12 months, with additional readings if a patient started exhibiting symptoms.
Atrial fibrillation is a condition that causes a quivering or irregular heartbeat that could lead to blood clots, stroke or heart failure.
To use the automated solution, a patient places fingers on two pads that pick up the heart rate and then communicates with a mobile device that is a personal ECG; it displays a waveform of the electrocardiogram that can be sent to a secure server for reading by a clinician.
“This is the first prospective randomized trial evaluating the ability of remote ECG acquisition and transmission with a handheld device to screen for atrial fibrillation (AF) in at-risk people over 65 years of age over an extended period of time,” researchers said in the report. “This approach is at least three times more likely to identify incident AF than routine care (at a cost of just $10,000 per case identified) and is a highly acceptable approach in this group of patients.”
Some 74 percent of patients completed the trial without missing a single week of submission of ECGs. The recommended twice-weekly screenings were successfully submitted by participants on average in 39 of the 52 weeks. Patients’ ages did not affect compliance rates, meaning that older patients in the cohort showed nearly identical compliance rates.
The overall cost of the project was $204,830, and a total of 60,440 ECGs were recorded. “In this study, we found that regular twice-weekly ECG recording and submission is logistically feasible over a one-year period and highly acceptable to persons over 65 years of age with increased risk of AF and stroke,” researchers assert.
The researchers further noted that the findings suggest the approach be considered for AF screening in routine practice, particularly with the highest-risk patients. “These results support consideration of evaluation in an appropriately powered, event-driven randomized trial to confirm clinical and cost effectiveness of such an approach to stroke prevention in AF.”
The complete study, “Assessment of remote heart rhythm sampling using the AliveCor Heart Monitor to screen for atrial fibrillation,” is available here in the journal Circulation.
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