Research
“My heart was stopping for twelve seconds at a time” – Wearable patch can spot danger in people with unexplained fainting
A Cambridge librarian has spoken about how a wearable heart monitor, fitted after visiting A&E due to unexplained fainting, helped doctors quickly spot his life-threatening heart problem. As a result of the British Heart Foundation-funded trial, John Moffett, 64, has been fitted with a pacemaker after recordings from the device showed that his fainting episodes were being caused by a dangerous heart rhythm problem.
John first went to A&E in January 2024 after experiencing heart flutters and unexplained fainting episodes for several months. He was kept in overnight for checks, agreed to join the trial and was quickly fitted with the monitor to record his heart rhythm.
The monitor is a patch designed to be worn in the centre of the chest, over the heart. It is much smaller and less intrusive than current monitors, and can be worn constantly throughout the day, even when in the shower. John was sent home to wear the patch for two weeks, whilst it recorded his heart rhythm, 24 hours a day.
After returning the patch to doctors to analyse his recording, he was quickly called back into hospital. “At night my heart had been pausing for up to twelve seconds at a time,” said John. “It was intending to give up the ghost if something wasn’t done.”
“Creeping up on me by stealth”
John was diagnosed with a heart rhythm problem called sinus node disease, which means his sinoatrial node (SA node) was not working properly. In his case, electrical signals were failing to reach the lower part of his heart putting him in serious danger of having a cardiac arrest. He was fitted with a pacemaker immediately to maintain his heart rhythm and hasn’t experienced a fainting episode since.
Reflecting on his experience, John said “The fainting wasn’t seriously impacting my life, but this problem was creeping up on me by stealth. I never thought this kind of thing would happen to me, and I’m relieved the pacemaker is in now. The heart patch couldn’t have been more effective for me.”
The trial, being led from the University of Edinburgh, has recruited 2,234 people with unexplained fainting from A&E departments across the UK. Researchers are assessing whether the new way of monitoring these patients, and starting monitoring immediately after the A&E department visit, leads to more heart rhythm problems being diagnosed and treated.
The researchers estimate that around 650,000 people go to A&E with unexplained fainting each year in the UK. Although in many cases the cause is harmless, fainting episodes can be a sign of abnormal heart rhythms, known as arrhythmias, some of which can be dangerous.
Arrhythmias in these patients are hard to diagnose. People who have fainted have usually recovered by the time they reach A&E, meaning their heart rhythm has likely returned to normal and signals recorded from their heart won’t show any abnormalities.
Encouraging start
Professor Matthew Reed, Professor of Emergency Medicine at the University of Edinburgh, who is leading the trial, said:
“John’s story shows the importance of monitoring the heart quickly and constantly after fainting, to ensure no abnormalities are missed. Only by catching glitches in the electrical activity of the heart can we diagnose a patient and take steps to ensure their heart continues to work effectively.
“We’re glad the new wearable patch was able to detect the danger John was in, so that doctors were able to act to help him. We hope this will be one example of many, and that the technology will lead to many more lives being saved than current methods.”
Currently, patients who report unexplained fainting are referred for tests such as a Holter monitor – an electrical heart signal recording device – to try and catch any signs of an arrhythmia. The Holter monitor is usually only worn for 48 hours, so can only identify an arrhythmia in this small time window, often weeks after the fainting event.
Researchers hope that quickly fitting the wearable patch can help solve this problem. Half of the trial participants, including John, are fitted with the patch immediately and told to keep it on so that it can record heart rhythm signals constantly for two weeks. The other half will receive the current standard care, involving referral to a cardiologist and receiving a Holter monitor within four weeks.
In a smaller study before the trial, the new heart patch detected an arrhythmia in three out of every 10 patients. In one out of every 10, the arrhythmia was symptomatic and serious. This is an improvement on current Holter monitoring, which only results in an arrhythmia diagnosis in less than 20 per cent of patients at best.
If similar results are seen in this larger trial, the new method for monitoring patients could be rolled out across the NHS to ensure more cases are caught and treated quickly.