open access

Vol 23, No 4 (2016)
ARRHYTMOLOGY Original articles
Published online: 2016-06-16
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A novel cross-sector telemedical approach to detect arrhythmia in primary care patients with palpitations using a patient-activated event recorder

Oliver Klein-Wiele, Markus Faghih, Stefan Dreesen, Rhyan Urbien, Marwan Abdelghafor, Kaffer Kara, Michael Schulte-Hermes, Marietta Garmer, Dietrich Grönemeyer, Birgit Hailer
DOI: 10.5603/CJ.a2016.0033
·
Pubmed: 27320955
·
Cardiol J 2016;23(4):422-428.

open access

Vol 23, No 4 (2016)
ARRHYTMOLOGY Original articles
Published online: 2016-06-16

Abstract

Background: Patient-activated event recorders (ER) can facilitate diagnosis in unclear palpi­tations, however impact of ER screening on further treatment in clinical routine is unknown. We investigated the feasibility and clinical value of a network-based telemetric monitoring using a patient activated ER.

Methods: The network consisted of 12 general practitioners (GP) and a department of car­diology (DC). GP-patients sent electrocardiograms (ECGs) twice daily and in case of palpitations. ECGs were transferred by email to GP and DC and analyzed independently by both. The therapeutic strategy was discussed between GP and DC. The monitoring period ended after 4 weeks or in case of detected arrhythmia.

Results: A group of 184 consecutive patients were retrospectively analyzed. Mean age was 57.5 ± 14.4 years (range 17–82), 104 (56.5%) were female. Significant arrhythmia occurred in 71 (38.5%) patients: Recurrence of known paroxysmal atrial fibrillation (AF; n = 27, 14.7%), de novo AF (n = 19, 10.3%), premature complexes/bigeminus (n = 13, 7.1%), sinus tachycar­dia (n = 7, 3.8%), atrioventricular nodal reentrant tachycardia (n = 3, 1.6%), and ventricular tachycardia (n = 2, 1.1%). A therapeutic consequence resulted in 63 (88.7%) patients with de­tected arrhythmia: new oral anticoagulation (n = 29, 40.8%), new antiarrhythmic medication (n = 27, 38.0%), behavioral intervention (n = 19, 26.8%), electrophysiology-study/catheter ablation (n = 4, 5.6%), cardioversion (n = 2, 2.8%), implantable cardioverter-defibrillator- -implantation (n = 1, 1.4%), and left atrial appendage occluder (n = 1, 1.4%).

Conclusions: The investigated cross-sector telemetric network is a feasible approach to detect arrhythmia in patients with palpitations and may have high impact on further treatment, notably in those at risk for stroke due to AF.

Abstract

Background: Patient-activated event recorders (ER) can facilitate diagnosis in unclear palpi­tations, however impact of ER screening on further treatment in clinical routine is unknown. We investigated the feasibility and clinical value of a network-based telemetric monitoring using a patient activated ER.

Methods: The network consisted of 12 general practitioners (GP) and a department of car­diology (DC). GP-patients sent electrocardiograms (ECGs) twice daily and in case of palpitations. ECGs were transferred by email to GP and DC and analyzed independently by both. The therapeutic strategy was discussed between GP and DC. The monitoring period ended after 4 weeks or in case of detected arrhythmia.

Results: A group of 184 consecutive patients were retrospectively analyzed. Mean age was 57.5 ± 14.4 years (range 17–82), 104 (56.5%) were female. Significant arrhythmia occurred in 71 (38.5%) patients: Recurrence of known paroxysmal atrial fibrillation (AF; n = 27, 14.7%), de novo AF (n = 19, 10.3%), premature complexes/bigeminus (n = 13, 7.1%), sinus tachycar­dia (n = 7, 3.8%), atrioventricular nodal reentrant tachycardia (n = 3, 1.6%), and ventricular tachycardia (n = 2, 1.1%). A therapeutic consequence resulted in 63 (88.7%) patients with de­tected arrhythmia: new oral anticoagulation (n = 29, 40.8%), new antiarrhythmic medication (n = 27, 38.0%), behavioral intervention (n = 19, 26.8%), electrophysiology-study/catheter ablation (n = 4, 5.6%), cardioversion (n = 2, 2.8%), implantable cardioverter-defibrillator- -implantation (n = 1, 1.4%), and left atrial appendage occluder (n = 1, 1.4%).

Conclusions: The investigated cross-sector telemetric network is a feasible approach to detect arrhythmia in patients with palpitations and may have high impact on further treatment, notably in those at risk for stroke due to AF.

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Keywords

event recorder, atrial fibrillation, palpitations, general practice, telemedicine, telecardiology

About this article
Title

A novel cross-sector telemedical approach to detect arrhythmia in primary care patients with palpitations using a patient-activated event recorder

Journal

Cardiology Journal

Issue

Vol 23, No 4 (2016)

Pages

422-428

Published online

2016-06-16

DOI

10.5603/CJ.a2016.0033

Pubmed

27320955

Bibliographic record

Cardiol J 2016;23(4):422-428.

Keywords

event recorder
atrial fibrillation
palpitations
general practice
telemedicine
telecardiology

Authors

Oliver Klein-Wiele
Markus Faghih
Stefan Dreesen
Rhyan Urbien
Marwan Abdelghafor
Kaffer Kara
Michael Schulte-Hermes
Marietta Garmer
Dietrich Grönemeyer
Birgit Hailer

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