Identification of the Arrhythmias and Myocardial Infraction in Pilgrims Visiting Kedarnath Temple in Uttarakhand Using a Smartphone 12-Lead Ecg Device

Abstract

Every year, about 1.5 million pilgrims visit the 14 km long Kedarnath temple trek on foot at the height of 3584 meters above sea level. In 2022, the months of May and June reported a drastic increase in mortality due to Myocardial infarction in the pilgrims. Hence, a health camp was organized for heart health checkups in the symptomatic pilgrims. In the heart checkup camp, screening of symptomatic pilgrims was done using the smartphone-based Spandan 12 lead ECG device developed by Sunfox Technologies Private Limited, India. A Standard operating procedure was followed for monitoring and follow-up of the pilgrims with ongoing arrhythmias or Myocardial Infarction. The ECGs of the pilgrims with persistent symptoms like palpitations, chest pain, shortness of breath, dizziness, and past medical history of hypertension, coronary interventions, smoking behavior, and diabetes were collected at the health camp. The reports with abnormal ECG were provided with immediate referral to the health care center. Whereas a tablet of 150 mg anti-platelet drug was given to pilgrims having critical and abnormal ECG. These pilgrims were immediately referred to the nearby district hospital. A total of 2343 pilgrims visited the Health camp for the screening, out of which 583 cases were pre-screened to be prone to cardiac abnormalities. The 12 lead ECGs collected from heart abnormalities prone patients were shared with a cardiologist at the Nodal center in Dehradun, Uttarakhand. 423 ECGs were interpreted as normal, 62 were abnormal, and 90 pilgrims were critical. Follow-ups taken after two days for pilgrims detected early for the abnormal and critical ECGs reported no casualties. Smartphone-based ECG device presents an impact in saving the lives of the people in Kedarnath by accessing the status of their cardiac health before trekking to the Kedarnath temple.