Antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during COVID-19 social distancing

Shah, Roshni; Kapoor, Ridhima; Bonnett, Colleen; Ottoboni, Linda; Tacklind, Christine; Tsiperfal, Angela; Pérez, Marco

doi:10.1093/ehjdh/ztab034

Cited by 9 publications

(10 citation statements)

References 9 publications

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“…After initial screening of titles and abstracts, 28 references were considered to be potentially relevant and ordered for full paper screening; of these 10 publications, 26,31,34,37,[39][40][41][42][43] relating to six studies, were included in the review. A further three publications, one provided by NICE/ Specialist Committee Members (SCMs) 14 and two provided by the manufacturer of KardiaMobile 6L, AliveCor, 51,52 were assessed and included in the review. These publications related to two additional studies and were all published in a journal, European Heart Journal -Digital Health, which is not yet indexed in the bibliographic databases searched.…”

Section: Methods Of Analysis/synthesismentioning

confidence: 99%

“…Based on the searches and inclusion screening described above, 13 publications, 14,26,31,34,37,[39][40][41][42][43]51,52 relating to 8 studies, and 2 additional unpublished reports, 53,54 were included in this review; the results section of this report cites studies using the primary publication only.…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…All eight 14,26,31,37,41,42,51,52 of the included studies were published, in full, in peer-reviewed journals.…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

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KardiaMobile 6L for measuring QT interval in people having antipsychotic medication to inform early value assessment: a systematic review

Westwood,

Armstrong,

Posadzki

et al. 2024

Health Technol Assess

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Background The indication for this assessment is the use of the KardiaMobile six-lead electrocardiogram device for the assessment of QT interval-based cardiac risk in service users prior to the initiation of, or for the monitoring of, antipsychotic medications, which are associated with an established risk of QT interval prolongation. Objectives To provide an early value assessment of whether KardiaMobile six-lead has the potential to provide an effective and safe alternative to 12-lead electrocardiogram for initial assessment and monitoring of QT interval-based cardiac risk in people taking antipsychotic medications. Review methods Twenty-seven databases were searched to April/May 2022. Review methods followed published guidelines. Where appropriate, study quality was assessed using appropriate risk of bias tools. Results were summarised by research question; accuracy/technical performance; clinical effects (on cardiac and psychiatric outcomes); service user acceptability/satisfaction; costs of KardiaMobile six-lead. Results We did not identify any studies which provided information about the diagnostic accuracy of KardiaMobile six-lead, for the detection of corrected QT-interval prolongation, in any population. All studies which reported information about agreement between QT interval measurements (corrected and/or uncorrected) with KardiaMobile six-lead versus 12-lead electrocardiogram were conducted in non-psychiatric populations, used cardiologists and/or multiple readers to interpret electrocardiograms. Where reported or calculable, the mean difference in corrected QT interval between devices (12-lead electrocardiogram vs. KardiaMobile six-lead) was generally small (≤ 10 ms) and corrected QT interval measured using KardiaMobile six-lead was consistently lower than that measured using 12-lead electrocardiogram. All information about the use of KardiaMobile six-lead, in the context of QT interval-based cardiac risk assessment for service users who require antipsychotic medication, was taken from retrospective surveys of staff and service users who had chosen to use KardiaMobile six-lead during pilots, described in two unpublished project reports. It is important to note that both these project reports relate to pilot studies which were not intended to be used in wider evaluations of KardiaMobile six-lead for use in the NHS. Both reports included survey results which indicated that the use of KardiaMobile six-lead may be associated with reductions in the time taken to complete an electrocardiogram and costs, relative to 12-lead electrocardiogram, and that KardiaMobile six-lead was preferred over 12-lead electrocardiogram by almost all responding staff and service users. Limitations There was a lack of published evidence about the efficacy of KardiaMobile six-lead for initial assessment and monitoring of QT interval-based cardiac risk in people taking antipsychotic medications. Conclusions There is insufficient evidence to support a full diagnostic assessment evaluating the clinical and cost effectiveness of KardiaMobile six-lead, in the context of QT interval-based cardiac risk assessment for service users who require antipsychotic medication. The evidence to inform the aims of this early value assessment (i.e. to assess whether the device has the potential to be clinically effective and cost-effective) was also limited. This report includes a comprehensive list of research recommendations, both to reduce the uncertainty around this early value assessment and to provide the additional data needed to inform a full diagnostic assessment, including cost-effectiveness modelling. Study registration This study is registered as PROSPERO CRD42022336695. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: NIHR135520) and is published in full in Health Technology Assessment; Vol. 28, No. 19. See the NIHR Funding and Awards website for further award information.

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Section: Methods Of Analysis/synthesismentioning

confidence: 99%

Section: Overview Of Included Studiesmentioning

confidence: 99%

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KardiaMobile 6L for measuring QT interval in people having antipsychotic medication to inform early value assessment: a systematic review

Westwood,

Armstrong,

Posadzki

et al. 2024

Health Technol Assess

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“…Successful outpatient initiation of sotalol initiation was performed without any adverse events. 114 A pharmacist-driven virtual clinic for outpatient sotalol loading and monitoring has since been safely piloted using online ECG and lab review, telephone contact, and remote QTc monitoring via the KardiaMobile ® 6L. 115 …”

Section: Virtual Clinicsmentioning

confidence: 99%

The digital journey: 25 years of digital development in electrophysiology from an Europace perspective

Svennberg,

Caiani,

Bruining

et al. 2023

Europace

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Aims Over the past 25 years there has been a substantial development in the field of digital electrophysiology (EP) and in parallel a substantial increase in publications on digital cardiology. In this celebratory paper, we provide an overview of the digital field by highlighting publications from the field focusing on the EP Europace journal. Results In this journey across the past quarter of a century we follow the development of digital tools commonly used in the clinic spanning from the initiation of digital clinics through the early days of telemonitoring, to wearables, mobile applications, and the use of fully virtual clinics. We then provide a chronicle of the field of artificial intelligence, a regulatory perspective, and at the end of our journey provide a future outlook for digital EP. Conclusion Over the past 25 years Europace has published a substantial number of papers on digital EP, with a marked expansion in digital publications in recent years.

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“…An important milestone in the ESC's digital roadmap was the recent launch of The European Heart Journal—Digital Health ( https://academic.oup.com/ehjdh ), dedicated to connecting the clinic with digital health technology advancements. It published recently two remarkable studies related to COVID-19: (i) Maurizi et al 9 presented ‘Use of smartphone-operated ECG for home ECG surveillance in COVID-19 patients’ and (ii) Shah et al 10 ‘Antiarrhythmic Drug Loading at Home Using Remote Monitoring: A Virtual Feasibility Study During COVID-19 Social Distancing’. The titles speak for themselves and both articles show not only the current benefits of digital health and telecardiology but also those for the future.…”

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confidence: 99%

The post-pandemic legacy: the breakthrough of digital health and telemedicine

Bruining

2021

Cardiovascular Research

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Antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during COVID-19 social distancing

Cited by 9 publications

References 9 publications

KardiaMobile 6L for measuring QT interval in people having antipsychotic medication to inform early value assessment: a systematic review

KardiaMobile 6L for measuring QT interval in people having antipsychotic medication to inform early value assessment: a systematic review

The digital journey: 25 years of digital development in electrophysiology from an Europace perspective

The post-pandemic legacy: the breakthrough of digital health and telemedicine

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