Initial Experience in Monitoring QT Intervals Using a Six-lead Contactless Mobile Electrocardiogram in an Inpatient Setting

Abstract

Mobile electrocardiograms (ECGs) (mECGs) using smartphone applications are an emerging technology. In the coronavirus disease 2019 (COVID-19) era, minimizing patient contact has gained increasing importance. Additionally, increased QT/corrected QT (QTc) monitoring has concurrently been required. The KardiaMobile 6L ECG device, cleared by the United States Food and Drug Administration (FDA) for recording ECGs, along with the KardiaStation tablet application is a platform (AliveCor, Mountain View, CA, USA) that addresses these two issues. A team of residents, fellows, hospitalists, and cardiologists identified inpatients in need of QT/QTc interval monitoring to pilot the adoption of a system composed of a KardiaMobile 6L ECG device with the accompanying KardiaStation tablet application. Concurrent standard ECGs provided validation. Adoption and performance issues were recorded. Four patients agreed to participate in QT/QTc interval monitoring, three of whom were positive for severe acute respiratory syndrome coronavirus 2 viral infection. After basic instructions were given to the patients and their clinical nurses, all patients recorded mECGs successfully. Patients were able to record their own mECG tracings at least once without any assistance. The 12-lead ECGs and mECGs each showed the correct rhythm, and the measured QTc intervals on each modality were consistently acceptable (< 500 ms). Contactless ECGs were successfully uploaded to KardiaStation for QT/QTc interval measurement and archiving. In this study, we showed that an FDA-cleared product, KardiaMobile 6L, has the ability to provide high-quality contactless ECGs for reliable QT/QTc interval measurements. Hospitalized patients were able to perform recordings when requested after receiving simple instructions at the time of first use. This technology has applications during the COVID-19 pandemic and beyond.

Portable single-lead electrocardiogram device is accurate for QTc evaluation in hospitalized patients

“…Unlike this 6-lead device, we used a single-lead device and found excellent agreement compared to the conventional 12-lead ECG when evaluating QTc using the Bazett formula, suggesting that a simpler device could be equally reliable. Future studies are needed to assess whether patients themselves, as reported by Frisch, could perform the measurement with a single-lead device ( 18 ).…”

The Relationship between Body Composition and ECG Ventricular Activity in Young Adults

“…Preliminary data indicate that the measured electrical intervals are close enough to allow the detection of clinically meaningful abnormalities [ 34 ]. These devices have good accuracy for reliable QT and QTc interval determination and, therefore, can be used in clinical trials [ 35 ]. In addition, this ECG recording variant is useful for obtaining information on cardiac rhythm and electrical intervals for patients who have difficulty achieving the classic 12-lead ECG, such as the existence of mental health diseases [ 36 ].…”