Elsevier

The American Journal of Cardiology

Volume 153, 15 August 2021, Pages 125-128
The American Journal of Cardiology

Usefulness of Mobile Electrocardiographic Devices to Reduce Urgent Healthcare Visits

https://doi.org/10.1016/j.amjcard.2021.05.027Get rights and content

Mobile electrocardiogram (mECG) devices are being used increasingly, supplying recordings to providers and providing automatic rhythm interpretation. Given the intermittent nature of certain cardiac arrhythmias, mECGs allow instant access to a recording device. In the current COVID-19 pandemic, efforts to limit in-person patient interactions and avoid overwhelming emergency and inpatient services would add value. Our goal was to evaluate whether a mECG device would reduce healthcare utilization overall, particularly those of urgent nature. We identified a cohort of KardiaMobile (AliveCor, USA) mECG users and compared their healthcare utilization 1 year prior to obtaining the device and 1 year after. One hundred and twenty-eight patients were studied (mean age 64, 47% female). Mean duration of follow-up pre-intervention was 9.8 months. One hundred and twenty-three of 128 individuals completed post-intervention follow-up. Patients were less likely to have cardiac monitors ordered (30 vs 6; p <0.01), outpatient office visits (525 vs 382; p <0.01), cardiac-specific ED visits (51 vs 30; p <0.01), arrhythmia related ED visits (45 vs 20; p <0.01), and unplanned arrhythmia admissions (34 vs 11; p <0.01) in the year after obtaining a KardiaMobile device compared to the year prior to obtaining the device. Mobile technology is available for heart rhythm monitoring and can give feedback to the user. This study showed a reduction of in-person, healthcare utilization with mECG device use. In conclusion, this strategy would be expected to decrease the risk of exposure to patients and providers and would avoid overwhelming emergency and inpatient services.

Section snippets

Methods

We performed a retrospective review of our institutional electronic health records and KardiaPro database for patients who had records for about 1 year prior to purchasing a KardiaMobile device. KardiaPro is a subscription database where ECG information can be stored by patients and reviewed by providers. We then prospectively followed them for 1 year after. We only included patients who had utilized their device at least once and are subscribed to KardiaPro. Data on baseline clinical

Results

A total of 128 patients were recruited in the study. Three patients were excluded from healthcare utilization analysis as they did not utilize their KardiaMobile at least once. Table 1 summarizes the baseline characteristics of included patients. Table 2 summarizes the indication for KardiaMobile use. Most patients utilized KardiaMobile for AF monitoring, be it paroxysmal or persistent (75.8%).

Pre- and post-KardiaMobile outcomes are shown in Table 3. Importantly, exposure to the device was

Discussion

In this study, we demonstrated that a commercially available mECG device was associated with a reduction in healthcare utilization. Importantly, patients with different arrhythmia diagnoses using KardiaMobile were included in this study. This suggests that the benefit in healthcare resource optimization can be seen in a varied population. Appropriately, the most common indication for its use was for AF monitoring, the most common clinical arrhythmia.10 Given the increasing prevalence of AF,

Author Contributions

DMJ and DRF developed the concept and co-wrote the manuscript. DMJ and CG performed data collection. JJ assisted in data collection and manuscript writing. Drew Johnson: conceptualization, investigation, writing – original draft, writing - review & editing, visualization, supervision, project administration. Joey Junarta: investigation, writing – review and editing, visualization. Christopher Gerace: investigation. Daniel Frisch: Conceptualization, writing – original draft, writing – review &

Disclosures

DRF reports consulting with AliveCor and receiving demonstration devices but no financial remuneration.

Acknowledgments

The authors would like to thank David Whellan, MD, for editing and Misung Yi, PhD, and Scott W. Keith, PhD, for assistance with statistical analysis.

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No funding was provided for this study.

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