Monitoring prolongation of QT interval in patients with multidrug-resistant tuberculosis and non-tuberculous mycobacterium using mobile health device AliveCor

Puranik, Shriya; Harlow, Christopher; Martín, Laura; Coleman, Meg; Russell, Georgina; Park, Mirae; Kon, Onn Min

doi:10.1016/j.jctube.2021.100293

Cited by 2 publications

(8 citation statements)

References 17 publications

(15 reference statements)

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“…The device proved useful for ECG monitoring in these patients, detecting ECG abnormalities significant enough to promote a change in treatment in 17.4% of them. Puranik et al ( 23 ) investigated the AliveCor device to monitor the QT interval in patients with multidrug-resistant tuberculosis and non-tuberculous mycobacterium. For 13 patients, a comparison was made between an automated QTc readout from the 12-lead ECG, and the mean QTc value was calculated from each patient's respective AliveCor device tracing (lead II).…”

Section: Resultsmentioning

confidence: 99%

Smart devices to measure and monitor QT intervals

Hoek,

Brouwer,

Voors

et al. 2023

Front. Cardiovasc. Med.

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Careful observation of the QT interval is important to monitor patients with long QT syndrome and during treatment with potentially QT-prolonging medication. It is also crucial in the development of novel drugs, in particular in case of a potential side effect of QT prolongation and in patients with increased risk of QT prolongation. The 12-lead electrocardiogram (ECG) is the gold standard to evaluate cardiac conduction and repolarization times. Smartwatches and smart devices offer possibilities for ambulatory ECG recording and therefore measuring and monitoring the QT interval. We performed a systematic review of studies on smartwatches and smart devices for QTc analysis. We reviewed PubMed for smartwatches and smart devices that can measure and monitor the QT interval. A total of 31 studies were included. The most frequent devices were (1) KardiaMobile 6L, a Food and Drug Administration-approved device for QTc analyses that provides a 6-lead ECG, (2) an Apple Watch, a smartwatch with an integrated ECG tool that allows recording of a single-lead ECG, and (3) the Withings Move ECG ScanWatch, an analog watch with a built-in single-lead ECG. The KardiaMobile 6L device and the Apple Watch provide accurate measurements of the QT interval, although the Apple Watch is studied in standard and non-standard positions, and the accuracy of QT measurements increased when the smartwatch was moved to alternative positions. Most studies were performed on patients, and limited results were available from healthy volunteers.

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Section: Resultsmentioning

confidence: 99%

Smart devices to measure and monitor QT intervals

Hoek,

Brouwer,

Voors

et al. 2023

Front. Cardiovasc. Med.

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“…15 Chapter 4 Systematic review results t he literature searches of bibliographic databases conducted for this EVA systematic review, including additional scoping searches conducted to identify costs and cost-effectiveness studies, identified 8505 unique references. 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.…”

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%

“…All eight of the included published studies were technical validation studies 14,31,37,41,51 or case series, 26,42,52 reporting some, very limited information relevant to research question 1, 'What is the accuracy/technical performance of KardiaMobile 6L, where the target condition is QTc prolongation, determined by standard 12-lead ECG (the reference standard method)?' one study 37 reported data (time to register an ECG) relevant to research question 3, 'What are the effects of using KardiaMobile 6L on service user acceptability/ satisfaction and on training and workflow issues?'…”

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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Monitoring prolongation of QT interval in patients with multidrug-resistant tuberculosis and non-tuberculous mycobacterium using mobile health device AliveCor

Cited by 2 publications

References 17 publications

Smart devices to measure and monitor QT intervals

Smart devices to measure and monitor QT intervals

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

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