P953Smartphone monitor kardia: an effective diagnostic tool for paroxysmal palpitations

Abstract

Abstract Funding Acknowledgements no grants to declare OnBehalf not applicable Background : Paroxysmal palpitations are diagnostic challenge because the ECG and the 24-hour holter ECG monitoring without palpitations is usually normal. We report a 1 year experience of a new diagnostic tool for paroxysmal palpitations: the smartphone monitor Kardia®. Patients with paroxysmal palpitation and negative 24 hour holter ECG was ask to sent iECG during symptoms during the 1 month follow-up. Results Between January and December 2018, 20 patients have received Kardia®, mean age 40 years, the mean duration kardia-monitoring was 26 days. A total of 235 iECGs were sent by email, a median of 6 iECG/patients. 9 (45%) patients remained without rhythmic diagnosis (sinus rhythm, normal heart rate), 11 (55%) patients had at least one pathological iECG: 4 atrial fibrillation, 4 junctional tachycardia including 1 with paroxysmal pre-excitation, 2 atrial flutters. These diagnosis had therapeutic consequences: 2 AF ablations, 2 AF treated by antiarythmic drugs (AAD), 2 atrial flutters ablation, 1 ILR was implanted for absence of diagnosis with kardia®. The other patients without diagnosis at the time of palpitations were reassured on the absence of cardiac rhythm disturbance. Conclusion The purchase of 5 Kardia® as a new diagnostic tool for paroxtysmal palpitations is a reasonable investment for a cardiology derpartment, the diagnostic performance is higher than current standards (24 hours holters ECG monitoring), since it allows an arhythmic diagnosis in more than 50% of cases in 1 mounth. The main limitation is the selection of patients, most often young, who already have a smartphone and can send an email. patient age (years) duration (days) i-ECG sent number diagnosis treatment patient 1 23 11 3 AF AF ablation patient 3 51 23 7 AF AA Drugs patient 10 65 20 5 AF AA Drugs patient 11 35 29 6 SVT : AVNRT no ablation patient 12 48 22 27 atrial flutter flutter ablation patient 13 34 1 13 SVT : AVNRT no ablation patient 14 56 7 18 atrial flutter flutter ablation patient 15 59 21 80 AF and PVC AF Ablation patient 16 50 1 3 SVT : AVRT no ablation patient 17 28 28 2 SVT : AVNRT no ablation patient 19 49 35 8 PVC AA Drugs 1 year kardia experience : diagnosis performance in the 11/20 patients with abnormal iECG Abstract Figure. iECG : termination of SVT (patient 17)