QT Interval Monitoring with Handheld Heart Rhythm ECG Device in COVID-19 Patients

Minguito‐Carazo, Carlos; Echarte-Morales, Julio; Benito‐González, Tomas; Castillo-García, Samuel Del; Rodríguez-Santamarta, Miguel; Sánchez-Muñoz, Enrique; Maniega, C Gonzalez; García-Bergel, Rubén; Menendez-Suarez, Paula; Prieto-González, Silvia; Palacios-Echavarren, Carmen; Borrego-Rodriguez, Javier; Flores-Vergara, Guisela; Iglesias-Garriz, Ignacio; Fernández‐Vázquez, Felipe

doi:10.5334/gh.916

Cited by 7 publications

(16 citation statements)

References 19 publications

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“…It was demonstrated that the KM-1l device has adequate precision and agreement compared to the standard 12-lead ECG. Minquito-Carazo et al ( 25 ) evaluated the feasibility of QTc monitoring with KardiaMobile 6L in 63 COVID-19 patients receiving therapies that could interfere with the QT interval. QTc could be measured in lead II in 84.5% of the registries.…”

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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“…Furthermore, the global pandemic further complicated cardiology services as COVID-19 eventually emerged as an airborne disease, and physical distancing had been carried out to prevent the spread of infection. Therefore, attempts were made to use portable ECG devices to minimize exposure and disease transmission [ 18 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Is T-Wave Alternans a Repolarization Abnormality Marker in COVID-19? An Investigation on the Potentialities of Portable Electrocardiogram Device

Tondas¹,

Munawar

Marcantoni

et al. 2023

Cardiol Res

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Background: Cardiac arrhythmias are significantly associated with poor outcomes in coronavirus disease 2019 patients. Microvolt T-wave alternans (TWA) can be automatically quantified and has been recognized as a representation of repolarization heterogeneity and linked to arrhythmogenesis in various cardiovascular diseases. This study aimed to explore the correlation between microvolt TWA and COVID-19 pathology.Methods: Patients suspected of COVID-19 in Mohammad Hoesin General Hospital were consecutively evaluated using Alivecor ® Kardiamobile 6L™ portable electrocardiogram (ECG) device. Severe COVID-19 patients or those who are unable to cooperate in active ECG self-recording were excluded from the study. TWA was detected and its amplitude was quantified using the novel enhanced adaptive match filter (EAMF) method.Results: A total of 175 patients, 114 COVID-19 patients (polymerase chain reaction (PCR)-positive group), and 61 non-COVID-19 pa-tients (PCR-negative group) were enrolled in the study. PCR-positive group was subdivided according to the severity of COVID-19 pathology into mild and moderate severity subgroups. Baseline TWA levels were similar between both groups during admission (42.47 ± 26.52 µV vs. 44.72 ± 38.21 µV), but higher TWA levels were observed during discharge in the PCR-positive compared to the PCR-negative group (53.45 ± 34.42 µV vs. 25.15 ± 17.64 µV, P = 0.03). The correlation between PCR-positive result in COVID-19 and TWA value was significant, after adjustment of other confounding variables (R 2 = 0.081, P = 0.030). There was no significant difference in TWA levels between mild and moderate severity subgroups in patients with COVID-19, both during admission (44.29 ± 27.14 µV vs. 36.75 ± 24.46 µV, P = 0.34) and discharge (49.47 ± 33.62 µV vs. 61.09 ± 35.99 µV, P = 0.33). Conclusions:Higher TWA values can be observed on follow-up ECG obtained during discharge in the PCR-positive COVID-19 patients.

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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%

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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QT Interval Monitoring with Handheld Heart Rhythm ECG Device in COVID-19 Patients

Cited by 7 publications

References 19 publications

Smart devices to measure and monitor QT intervals

Smart devices to measure and monitor QT intervals

Is T-Wave Alternans a Repolarization Abnormality Marker in COVID-19? An Investigation on the Potentialities of Portable Electrocardiogram Device

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

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