Background: One disadvantage of currently available loop recorders is the long “time lag” between recording an electrocardiogram (ECG), establishing a diagnosis, and taking appropriate medical measures. Cellular communication with the Cardio R® loop recorder (introduced in 2009), which uses digital technology to transmit cardiac recordings and symptom descriptions, easily overcomes this problem.
Objective: To assess the Cardio R® device’s efficacy in detecting arrhythmias which may account for symptoms that were not observed on regular office ECGs or on traditional 24-hour Holter cardiac monitoring.
Methods: Cardio R® recordings are diagnosed almost immediately by the on-duty medical team at 'SHL'-Telemedicine's call center. Users can concomitantly relay symptom descriptions from a prepared list, thereby enabling correlation between symptoms and cardio rhythm tracings. The users and/or their physicians receive updates or instructions, or a mobile intensive care unit is dispatched, depending upon the displayed rhythm, the described symptoms and the referring physician's orders.
Results: Between January 2009–December 2013, a total of 56,552 ECG transmissions were received from 2,166 patients (mean±SD age 58±19 years, range 10-95; 61% females) who completed a 1-month trial with the Cardio R® device. There were 26±45 transmissions per patient. The leading complaints were palpitations (n=1,534 patients), pre-syncope (n=532 patients) and chest pain (n=100 patients). A total of 27,617 (49%) transmissions were made by patients who were in the midst of experiencing the same cardiac complaint(s) for which they were referred. The Cardio R® device displayed a confirmatory disturbance in rhythm in 91% of these cases. The interval between transmission until diagnosis of the recorded rhythm was 9 minutes (range 6-20 minutes), and 2±4 days elapsed until transmission of the first symptomatic episode.
Conclusions: The Cardio R® device enabled prompt ECG interpretations to guide interventions for managing cardiac-relevant complaints.
