Smartphone ECG could be used in A&E to detect serious heart conditions

4 March 2019        

Category: Research

A smartphone-based ECG recorder is five times more effective at diagnosing heart rhythm problems than standard tests, according to new research we've part-funded published in EClinicalMedicine.

Someone using the device

Researchers at the University of Edinburgh and NHS Lothian carried out the first randomised control trial of the device, the AliveCor® KardiaMobile, in 243 people presenting with heart palpations or near blackout at 15 Emergency Departments across the UK. The device enabled doctors to diagnose the cause of the palpitations in over 40 per cent more patients than standard tests alone.

Each year in the UK there are hundreds of thousands of visits to Emergency Departments by people experiencing palpitations, where heartbeats suddenly become 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. However, they can also be caused by serious underlying heart rhythm disorders such as atrial fibrillation, which can lead to a stroke.

Diagnosing the exact underlying cause of palpations or pre-syncope in the Emergency Department is often difficult. An electrocardiogram (ECG) is used to detect the heart rhythm and diagnose the patient. However, by the time the patient has made it to the Emergency Department they have often recovered and their ECG is normal.

Researchers gave 124 patients the KardiaMobile device to take home. The device is stuck 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.

The 116 patients not given the device underwent standard tests and follow-up and, if undiagnosed, were asked to attend the Emergency Department or their GP surgery if they experienced further symptoms.

After 90 days ECGs taken by the device allowed doctors to diagnose 56 per cent of patients in an average of 9.5 days. Only 10 per cent of patients given standard care were diagnosed, with an average time to diagnosis of 43 days.

The device also cut the cost of a diagnosis by an average of £921, from £1395 to £474, due to the relative higher costs of tests such as 24 hour, 48 hour and 7 day Holter monitoring used in the standard care group.  

Professor Jeremy Pearson, our Associate Medical Director, 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.”

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