AFib: A guide for digital pulse checks

Patient guidance:
  • Check your pulse once daily and/or during any symptoms as instructed by your provider.  A good tip to check once a morning or at night when waking up or going to bed.
  • If the auto interpretation of the ECG is ‘normal sinus rhythm’ - great!
  • If the ECG is unexpectedly abnormal or you are having symptoms and the ECG is ‘readable’, considering sharing with your provider.
  • To share your ECG:
    1. Open the ECG in your Alivecor app on your mobile device
    2. Select ‘download PDF’ option
    3. When prompted, entered a password to encrypt the ECG – use ‘1234’ or one of your choice.
    4. Once the PDF opens, use the share link to send the PDF to the MyPennMedicine app.  Compose a message to your provider and the PDF will be embedded in the message.
    5. Include the password and the reason for sharing the ECG in the message.

SUGGESTED

AliveCor KardiaMobile Personal ECG Monitor + App

Full description

Wearables Smartphone

Personal ECG monitor that syncs with an app with AI-based arrhythmia detection.

AliveCor KardiaMobile Personal ECG Monitor + App

Wearables Smartphone

Description

Personal ECG monitor that syncs with an app with AI-based arrhythmia detection.

Clinical Indication

  • Atrial fibrillation

  • Bradycardia

  • Tachycardia

  • Premature ventricular contractions

  • Supraventricular ectopy

  • QTc monitoring

  • Self-monitoring in EP

Evidence Base

  • Site with 109 peer-reviewed articles in numerous categories in relation to Kardia device

  • Not tested/recommended for use with PPMs/ICDs

Quality Control

Device and app are FDA-cleared.

Models

  • KardiaMobile: contains one lead

  • KardiaMobile 6L: contains six leads

  • KardiaCare: Add-on software package that allows for detection of PVCs, supraventricular ectopy, and QTc length

Technical Aspects/Integration

  • Captures single lead ECG (30-second to 5-minute recordings) and provides instant analysis of various rhythms (AF, NSR, brady, tachy, unclassified/inconclusive). Sends data to mobile app via Bluetooth, where data is stored and can be emailed or sent via MPM to clinician.

  • Works with most Apple or Android smartphones and tablets

  • Not currently connected to Epic

Procurement/Cost

Available on vendor site or Amazon. KardiaMobile is $89, KardiaMobile 6L is $149, KardiaCare is $9.99 monthly.

Clinical Lead

Amaryah Yaeger, David Lin

Entry Author and Date

Amaryah Yaeger, April 2020; Allison Hare, February 2021

Apple Watches

Full description

Biosensors Smartphone Smart watch

Smart watch with features including heart rate and rhythm detection, pedometer, and sleep tracking.

Apple Watches

Biosensors Smartphone Smart watch

Description

Smart watch with features including heart rate and rhythm detection, pedometer, and sleep tracking.

Evidence Base

Apple Heart Study showed that among participants who received notification of an irregular pulse, 34% had atrial fibrillation on subsequent ECG patch readings and 84% of notifications were concordant with atrial fibrillation. Perez MV, Mahaffey KW, Hedlin H, Rumsfeld JS, Garcia A, Ferris T, Balasubramanian V, Russo AM, Rajmane A, Cheung L, Hung G, Lee J, Kowey P, Talati N, Nag D, Gummidipundi SE, Beatty A, Hills MT, Desai S, Granger CB, Desai M, Turakhia MP; Apple Heart Study Investigators. Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation. N Engl J Med. 2019 Nov 14;381(20):1909-1917.

Quality Control

ECG app is FDA approved to determine the presence of atrial fibrillation or normal sinus rhythm, but is not recommended for users with other known arrhythmias or users under the age of 22. Blood Oxygen app is not FDA-approved for clinical use.

Models

  • Series 6

    • Procurement/cost: $499 with GPS + cellular connectivity; $399 with GPS connectivity

    • Technical aspects/integration: Capable of detecting atrial fibrillation/normal sinus rhythm and providing a one-lead ECG reading through a one-lead ECG and third-generation optical heart sensor. Also hosts “Blood Oxygen app” which detects blood oxygenation through clusters of LED lights and photodiodes embedded in the watch backing. Syncs to Health app on iPhone and all Apple products via Bluetooth. Enabled with GPS and cellular connectivity

  • SE

    • Procurement/cost: $329 with GPS + cellular connectivity; $279 with GPS connectivity

    • Technical aspects/integration: Provides users notifications for high or low heart rates or irregular heart rhythms through a second-generation optical heart sensor. Syncs to Health app on iPhone and all Apple products via Bluetooth. Enabled with GPS and cellular connectivity

  • Series 3

    • Procurement/cost: $199 with GPS connectivity

    • Technical aspects/integration: Provides users notifications for high or low heart rates or irregular heart rhythms through an optical heart sensor. Syncs to Health app on iPhone and all Apple products via Bluetooth. Enabled with GPS connectivity

Entry Author and Date

Jonathan Wakim, October 2020; Allison Hare, March 2021