Vol 28, No 4 (2021)
Original Article
Published online: 2019-01-02

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Kardia Mobile applicability in clinical practice: A comparison of Kardia Mobile and standard 12-lead electrocardiogram records in 100 consecutive patients of a tertiary cardiovascular care center

Lukasz Koltowski1, Pawel Balsam1, Renata Glowczynska1, Jakub K. Rokicki1, Michal Peller1, Jakub Maksym1, Leszek Blicharz1, Kacper Maciejewski1, Magdalena Niedziela1, Grzegorz Opolski1, Marcin Grabowski1
Pubmed: 30644079
Cardiol J 2021;28(4):543-548.


Background: Mobile devices are gaining a rising number of users in all countries around the globe. Novel solutions to diagnose patients with out-of-hospital onset of arrhythmic symptoms can be easily used to record such events, but the effectiveness of these devices remain unknown.
Methods: In a group of 100 consecutive patients of an academic cardiology care center (mean age 68 ± 14.2 years, males: 66%) a standard 12-lead electrocardiogram (ECG) and a Kardia Mobile (KM) record were registered. Both versions were assessed by three independant groups of physicians.
Results: The analysis of comparisons for standard ECG and KM records showed that the latter is of lower quality (p < 0.001). It was non-inferior for detection of atrial fibrillation and atrial flutter, showed weaker rhythm detection in pacemaker stimulation (p = 0.008), and was superior in sinus rhythm detection (p = 0.02), though. The sensitivity of KM to detect pathological Q-wave was low compared to specificity (20.6% vs. 93.7%, respectively, p < 0.001). Basic intervals measured by the KM device, namely PQ, RR, and QT were significantly different (shorter) than those observed in the standard ECG method (160 ms vs. 180 ms [p < 0.001], 853 ms vs. 880 ms [p = 0.03] and 393 ms vs. 400 ms
[p < 0.001], respectively).
Conclusions: Initial and indicative value of atrial fibrillation and atrial flutter detection in KM is comparable to results achieved in standard ECG. KM was superior in detection of sinus rhythm than eye-ball evaluation of 12-lead ECG. Though, the PQ and QT intervals were shorter in KM as compared to 12-lead ECG. Clinical value needs to be verified in large studies, though.

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  1. Baranowski R, Bieganowska K, Kozłowski D, et al. Zalecenia dotyczące stosowania rozpoznań elektrokardiograficznych. Kardiol Pol. 2010; 68: 335–390.
  2. Olgun Kucuk H, Kucuk U, Yalcin M, et al. Time to use mobile health devices to diagnose paroxysmal atrial fibrillation. Int J Cardiol. 2016; 222: 1061.
  3. Tarakji KG, Wazni OM, Callahan T, et al. Using a novel wireless system for monitoring patients after the atrial fibrillation ablation procedure: the iTransmit study. Heart Rhythm. 2015; 12(3): 554–559.
  4. Pruszczyk P, Tomaszuk-Kazberuk A, Słowik A, et al. Management of bleeding or urgent interventions in patients treated with direct oral anticoagulants: 2017 recommendations for Poland. Pol Arch Intern Med. 2017; 127(5): 343–351.
  5. Chung EH, Guise KD. QTC intervals can be assessed with the AliveCor heart monitor in patients on dofetilide for atrial fibrillation. J Electrocardiol. 2015; 48(1): 8–9.
  6. Nguyen HH, Van Hare GF, Rudokas M, et al. SPEAR Trial: Smartphone Pediatric ElectrocARdiogram Trial. PLoS One. 2015; 10(8): e0136256.
  7. Narasimha D, Hanna N, Beck H, et al. Validation of a smartphone-based event recorder for arrhythmia detection. Pacing Clin Electrophysiol. 2018; 41(5): 487–494.
  8. Desteghe L, Raymaekers Z, Lutin M, et al. Performance of handheld electrocardiogram devices to detect atrial fibrillation in a cardiology and geriatric ward setting. Europace. 2017; 19(1): 29–39.
  9. Guhl EN, Schlusser CL, Henault LE, et al. Rationale and design of the Atrial Fibrillation health Literacy Information Technology Trial: (AF-LITT). Contemp Clin Trials. 2017; 62: 153–158.
  10. Treskes RW, Gielen W, Wermer MJ, et al. Mobile phones in cryptogenic strOke patients Bringing sIngle Lead ECGs for Atrial Fibrillation detection (MOBILE-AF): study protocol for a randomised controlled trial. Trials. 2017; 18(1): 402.
  11. Barbagelata A, Bethea CF, Severance HW, et al. Smartphone ECG for evaluation of ST-segment elevation myocardial infarction (STEMI): Design of the ST LEUIS International Multicenter Study. J Electrocardiol. 2018; 51(2): 260–264.
  12. Muhlestein JB, Le V, Albert D, et al. Smartphone ECG for evaluation of STEMI: results of the ST LEUIS Pilot Study. J Electrocardiol. 2015; 48(2): 249–259.
  13. Priori SG, Blomström-Lundqvist C, Mazzanti A, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2015; 36(41): 2793–2867.
  14. Solomon MD, Yang J, Sung SH, et al. Incidence and timing of potentially high-risk arrhythmias detected through long term continuous ambulatory electrocardiographic monitoring. BMC Cardiovasc Disord. 2016; 16: 35.
  15. Roffi M, Patrono C, Collet JP, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016; 37(3): 267–315.
  16. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991; 22(8): 983–988.
  17. Camm AJ, Lip GYH, De Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J. 2012; 33(21): 2719–2747.
  18. Michniewicz E, Mlodawska E, Lopatowska P, et al. Patients with atrial fibrillation and coronary artery disease - Double trouble. Adv Med Sci. 2018; 63(1): 30–35.
  19. Sanna T, Diener HC, Passman RS, et al. CRYSTAL AF Investigators. Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med. 2014; 370(26): 2478–2486.
  20. Gladstone DJ, Dorian P, Spring M, et al. Atrial fibrillation in patients with cryptogenic stroke. N Engl J Med. 2014; 370(26): 2467–2477.
  21. Lilli A, Di Cori A. The cold facts of long-term ECG monitoring. Expert Rev Cardiovasc Ther. 2015; 13(2): 125–127.
  22. Halcox JPJ, Wareham K, Cardew A, et al. Assessment of Remote Heart Rhythm Sampling Using the AliveCor Heart Monitor to Screen for Atrial Fibrillation: The REHEARSE-AF Study. Circulation. 2017; 136(19): 1784–1794.
  23. Rattanawong P, Upala S, Riangwiwat T, et al. Atrial fibrillation is associated with sudden cardiac death: a systematic review and meta-analysis. J Interv Card Electrophysiol. 2018; 51(2): 91–104.
  24. Klein-Wiele O, Faghih M, Dreesen S, et al. A novel cross-sector telemedical approach to detect arrhythmia in primary care patients with palpitations using a patient-activated event recorder. Cardiol J. 2016; 23(4): 422–428.
  25. Bloss CS, Wineinger NE, Peters M, et al. A prospective randomized trial examining health care utilization in individuals using multiple smartphone-enabled biosensors. PeerJ. 2016; 4: e1554.
  26. Choo KY, Ling HC, Lo YC, et al. Android based self-diagnostic electrocardiogram system for mobile healthcare. Technol Health Care. 2015; 23 Suppl 2: S435–S442.
  27. Miao F, Cheng Y, He Yi, et al. A wearable context-aware ECG monitoring system integrated with built-in kinematic sensors of the smartphone. Sensors (Basel). 2015; 15(5): 11465–11484.
  28. Cinaglia P, Tradigo G, Guzzi PH, et al. Design and Implementation of a Telecardiology System for Mobile Devices. Interdiscip Sci. 2015; 7(3): 266–274.
  29. Balsam P, Gawalko M, Lodziński P, et al. Atrioventricular block registration with smart phone associated ECG device. Heart Beat J. 2017; 1: 54–55.