Remote monitoring of the cardiac rhythm: where do we stand today?

Deftereos, Spyros; Papoutsidakis, Nikolaos; Giannopoulos, George; Kossyvakis, Charalambos; Lekakis, J.

doi:10.1002/cce2.36

Cited by 7 publications

(7 citation statements)

References 43 publications

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“…The present landscape of ECG monitoring includes Holter monitors which allow up to 14 days of consecutive recording, external or implanted loop recorders and pacemakers or implanted defibrillators. 3 The patient experience with these devices vary, with issues such as poor long-term compliance, skin-related problems from external electrodes and low motivation particularly in the absence of frequent or recurrent symptoms hindering diagnostic yield. 4 Results from the CRYSTAL-AF and EMBRACE trials have demonstrated the value of longer periods of ECG monitoring in detecting new episodes of atrial fibrillation in patients with prior cryptogenic stroke or transient ischemic attack.…”

Section: Discussionmentioning

confidence: 99%

Performance and Integration of Smartphone Wireless ECG Monitoring into the Enterprise Electronic Health Record: First Clinical Experience

Cho

Almeida

Gang

et al. 2022

Clin Med Insights Case Rep

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Introduction: Patient initiated, remote cardiac monitoring has proved to be a significant advance in the diagnosis and management of arrhythmias. Further improvements in ease of use and access to results will further improve health outcomes and cost-effectiveness. Here we describe a proof-of-concept evaluation to assess the feasibility of successfully implementing a cloud-based management system using KardiaPro (KP) for remote electrocardiogram (ECG) monitoring to interface into EPIC, an enterprise electronic health record (EHR) system. Methods: The KP management system was embedded using hypertext markup language (HTML) code directly into the EHR. Encrypted credentials and patient data were bundled with an application programming interface key allowing linkage of remote monitoring from patients’ smartphones. During the time of implementation, a total of 322 patients and 32 179 ECGs were recorded. Results: The KP-EHR interface provided full functionality, allowing detection, interpretation and documentation of atrial fibrillation (AF), flutter events, ventricular tachycardia, and complete heart block. Our study focused on KP’s detection of AF, and 16.7% of tracings were classified as probable AF with only 2.3% of tracings not analyzed by the KP algorithm because of tracings that were too noisy or truncated. Enhanced management was facilitated with clinical information immediately accessible. Blinded physician ECG review validated the KP proprietary algorithm interpretation and ECGs. Conclusions: Direct integration of KP into EHR was successful and practical. It allows for historical, point of care and immediate retrieval of remote ambulatory monitoring data and documentation into the electronic health record. KP EHR integration warrants further study as it has the potential to improve cost-effectiveness and clinical diagnostic value, leading to improvements in delivery of patient care.

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Section: Discussionmentioning

confidence: 99%

Performance and Integration of Smartphone Wireless ECG Monitoring into the Enterprise Electronic Health Record: First Clinical Experience

Cho

Almeida

Gang

et al. 2022

Clin Med Insights Case Rep

View full text Add to dashboard Cite

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Section: Introductionmentioning

confidence: 99%

Personalized Health and Precision Medicine in Practice

2024

Frontiers Research Topics

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Frontiers is more than just an open access publisher of scholarly articles: it is a pioneering approach to the world of academia, radically improving the way scholarly research is managed. The grand vision of Frontiers is a world where all people have an equal opportunity to seek, share and generate knowledge. Frontiers provides immediate and permanent online open access to all its publications, but this alone is not enough to realize our grand goals. Frontiers journal seriesThe Frontiers journal series is a multi-tier and interdisciplinary set of openaccess, online journals, promising a paradigm shift from the current review, selection and dissemination processes in academic publishing. All Frontiers journals are driven by researchers for researchers; therefore, they constitute a service to the scholarly community. At the same time, the Frontiers journal series operates on a revolutionary invention, the tiered publishing system, initially addressing specific communities of scholars, and gradually climbing up to broader public understanding, thus serving the interests of the lay society, too. Dedication to qualityEach Frontiers article is a landmark of the highest quality, thanks to genuinely collaborative interactions between authors and review editors, who include some of the world's best academicians. Research must be certified by peers before entering a stream of knowledge that may eventually reach the public -and shape society; therefore, Frontiers only applies the most rigorous and unbiased reviews. Frontiers revolutionizes research publishing by freely delivering the most outstanding research, evaluated with no bias from both the academic and social point of view. By applying the most advanced information technologies, Frontiers is catapulting scholarly publishing into a new generation. What are Frontiers Research Topics?Frontiers Research Topics are very popular trademarks of the Frontiers journals series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area.

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“…Patients wear such a device for the desired period, then return the recorder box to the hospital, where the data are analyzed, and the results are reported to the patients. Other conventional tests include x-rays, echocardiography, or an electrophysiology study (Deftereos et al, 2016;Schweizerische Herzstiftung, 2022). If these examinations or short-term cardiac monitoring do not yield results, long-term Current cardiac monitors are barely the size of a triple-A battery, weigh about 4 grams, and are made of titanium, sapphire, parylene, silicone, or iridium components that protect the electronics and make them compatible with human tissue.…”

Section: Introductionmentioning

confidence: 99%

The illusion of immediacy: on the need for human synchronization in data-intensive medicine

Arx

2023

Front. Sociol.

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Medical practice is increasingly shaped by big data sets and less by patient narratives. Data-intensive medicine promises to directly connect the patients with the clinic. Instead of medical examinations taking place at bedside and discrete moments, sensor-based technologies continuously monitor a certain body parameter and automatically transfer the data via a telemedical system. Based on a qualitative study of remote cardiac monitoring, I explore how the uncoupling of processes that used to happen in one place, changes the way diagnosis is made. Using ethnographic observations and semi-structured interviews with patients and tele-nurses of two university hospitals in Switzerland, I describe remote cardiac monitoring as a data network. The perception of being constantly connected to the hospital resulted in a reassuring effect among patients and healthcare professionals. Moreover, the notion of an automatically synchronized data network led patients to expect immediate feedback from the hospital as soon as an irregularity was detected. However, it obscured the fact that although the inserted sensor monitors the heart around the clock, the data is transmitted only once a day, and the tele-nurses only work during office hours, from Monday to Friday. I call this misperception “illusion of immediacy”. It takes time to accurately correlate and interpret a recorded episode with other types of data, such as the last hospital visit, comorbidities, and/or the actual situation in which the recording was made. Accordingly, tele-nurses and cardiologists play a central and privileged role in the data network. The findings highlight the importance of synchronizing the different temporalities that coexist in the patient remote monitoring data network in order to generate meaningful knowledge that ultimately leads to a diagnosis.

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Remote monitoring of the cardiac rhythm: where do we stand today?

Cited by 7 publications

References 43 publications

Performance and Integration of Smartphone Wireless ECG Monitoring into the Enterprise Electronic Health Record: First Clinical Experience

Performance and Integration of Smartphone Wireless ECG Monitoring into the Enterprise Electronic Health Record: First Clinical Experience

Personalized Health and Precision Medicine in Practice

The illusion of immediacy: on the need for human synchronization in data-intensive medicine

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