Reed, M.J.; Muir, A.; Cullen, J.; Murphy, R.; Pollard, V.; Zangana, G.; Krupej, S.; Askham, S.; Holdsworth, P.; Davies, L. Establishing a Smartphone Ambulatory ECG Service for Patients Presenting to the Emergency Department with Pre-Syncope and Palpitations. Medicina2021, 57, 147.
Reed, M.J.; Muir, A.; Cullen, J.; Murphy, R.; Pollard, V.; Zangana, G.; Krupej, S.; Askham, S.; Holdsworth, P.; Davies, L. Establishing a Smartphone Ambulatory ECG Service for Patients Presenting to the Emergency Department with Pre-Syncope and Palpitations. Medicina 2021, 57, 147.
Reed, M.J.; Muir, A.; Cullen, J.; Murphy, R.; Pollard, V.; Zangana, G.; Krupej, S.; Askham, S.; Holdsworth, P.; Davies, L. Establishing a Smartphone Ambulatory ECG Service for Patients Presenting to the Emergency Department with Pre-Syncope and Palpitations. Medicina2021, 57, 147.
Reed, M.J.; Muir, A.; Cullen, J.; Murphy, R.; Pollard, V.; Zangana, G.; Krupej, S.; Askham, S.; Holdsworth, P.; Davies, L. Establishing a Smartphone Ambulatory ECG Service for Patients Presenting to the Emergency Department with Pre-Syncope and Palpitations. Medicina 2021, 57, 147.
Abstract
Background and Objectives: The IPED study showed that a smartphone-based event recorder increased the number of patients in whom an ECG was captured during symptoms over five-fold to more than 55% at 90 days compared to standard care [1] and concluded that this safe, non-invasive and easy to use device should be considered part of on-going care to all patients presenting acutely with unexplained palpitations or pre-syncope. This study reports the process of establishing a smartphone palpitation and pre-syncope service. Materials and Methods: A clinical Standard Operating Procedure (SOP) was devised, and funding was secured through a business case for the purchase of 40 AliveCor devices in the first instance. The clinic was launched on 22nd July 2019. Results: Between 22nd July 2019 and 31st October 2019, 68 patients seen in the ED with palpitations or pre-syncope were referred to SPACC. 30 were male and 38 female and mean age was 45.8 (SD 15.1) with a range from 18 to 80 years. 50 (74%) patients underwent full investigation. 7 (11%) patients were deemed on first assessment to have non-cardiac palpitations and were not fitted with the device. All patients who underwent full investigation achieved symptomatic rhythm correlation most with sinus rhythm, ventricular ectopics or bigeminy. A symptomatic cardiac dysrhythmia was detected in 6 (8.8%) patients. 3 patients had supraventricular tachycardia; SVT (4%), 2 had atrial fibrillation (3%) and 1 atrial flutter (2%). Qualitative feedback from the SPACC team suggested several areas where improvement to the clinic could be made. Conclusion: We believe a smartphone palpitation service based in ambulatory care is simple to implement and is effective at detecting cardiac dysrhythmia in ED palpitation patients.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Matthew J Reed
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