Usefulness of a smartphone-based event recorder for ambulatory patients presenting with palpitations

Abstract

Abstract Background Palpitations are a common complaint among patients seen by primary care physicians (16%). Recent technological advances have led to several novel electrocardiographic monitoring devices. AliveCor Kardia Mobile® (AliveCor, Inc., Mountain View, CA, USA) is a smartphone-based event recorder that allows take an electrocardiogram (ECG) recording during 30 seconds. The usefulness of this device has been studied in atrial fibrillation screening, however, its usefulness in the diagnosis of palpitations is not well known. Objective Evaluate the diagnostic yield of the AliveCor Kardia Mobile® device in unselected patients referred to the cardiologist for the study of palpitations. Methods Uni-centre retrospective study. From September 2018 to October 2020, consecutive patients with palpitations referred to cardiology department were included. After an initial evaluation it was decided monitoring ECG of these patients with this device if they had access to a compatible smartphone. They were instructed to record ECG when they had symptoms. ECG tracings and clinical characteristics were analysed. Results 152 patients were included. Mean age 42±15 years, 68% female. Most of the patients did not have heart disease and about 25% had a history of anxiety-depressive syndrome (Table 1). After monitoring, 31 (20%) patients had rhythm disturbances during symptoms, 82 (54%) patients had no rhythm disturbances related to the symptoms and 39 (26%) patients had no symptoms. Table 2 shows the electrocardiographic findings. Patients with palpitations of arrhythmic origin were older and presented less anxiety/depression (Table 1). Age was the only independent predictor of palpitations of arrhythmic origin (OR, × year: 1.03, 95% CI 1.01–1.06; p=0.035). Conclusions The AliveCor Kardia Mobile® device is easy to use and diagnosed the aetiology of palpitations in a high proportion of patients (74%) referred for specialist evaluation. Funding Acknowledgement Type of funding sources: None.