Trends in the Diagnosis of Atrial Fibrillation – Event ECG and Tele Holter

The heart is the most important and hardworking muscle of the human body. It constantly pumps oxygenated blood straight into the blood vessels so that all cells can receive the right amount of nutrients needed for proper functioning. However, not all of us are aware of what the heart actually looks like, how tragic cardiac disorders can be, or how anomalies can be detected and diagnosed efficiently.

A few words about the heart

The human heart consists of two chambers and two atria separated from each other by a septum.  But what does the work of the heart muscle look? Blood vessels transport oxygen-poor blood from the organs to the right ventricle. Thanks to the work of the heart, the blood goes to the lungs, where it is properly oxygenated and sent through the pulmonary veins straight to the left atrium of the heart, to finally go to the left ventricle of the heart muscle. Only then can the heart, with the help of arteries (including the aorta) pump oxygenated blood to all organs and tissues of the body. Atrioventricular valves (mitral on the left and tricuspid on the right) also play an important role in this process – without them, proper blood circulation could not take place.

However, the proper functioning of the heart can be disturbed, and arrhythmia occurs when this happens. A special type of arrhythmia is atrial fibrillation, which, according to the European Society of Cardiology (ESC), affects about 250,000 people in Poland, although in the medical community sometimes even 700,000 cases are mentioned. In 2016, 43.6 million people worldwide were found to have atrial fibrillation1. A group at particular risk are patients struggling with other diseases, such as hypertension, obesity, diabetes or obstructive sleep apnea.

Atrial fibrillation – is it dangerous?

Let’s start from the beginning – what is atrial fibrillation, and why can it be dangerous for us? Atrial fibrillation is a type of arrhythmia. It presents as uncoordinated, agitated work of the atria (referred to as tremore), which may also be accompanied by accelerated action of the heart chambers.

Atrial fibrillation is particularly dangerous because it causes blood flow disorders and, consequently, also increases the risk of life-threatening thrombi. It is worth bearing in mind that a detached fragment of a thrombus can close the cerebral artery in the blink of an eye and cause a stroke. Another equally serious complication of atrial fibrillation is heart failure, which, like a stroke, can be fatal. 

Drugs can prevent the above complications of atrial fibrillation, but in order to be able to use them before complications occur, it is necessary to detect atrial fibrillation early enough. This can be difficult, because sometimes atrial fibrillation is an asymptomatic arrhythmia, meaning that the patient does not feel irregularities in the work of the heart. Therefore, efficient diagnostics are crucial.

New trends in the diagnosis of cardiac diseases

The basic tests to be performed during the diagnosis of cardiac disorders are resting ECG and Holter ECG recording. More modern, telemedicine technologies that allow the detection of atrial fibrillation are also gaining popularity and accessibility. However, it is worth being careful in their use – as many of them have not been clinically approved. Examples of proven, certified solutions helpful in cardiac diagnostics are the ECG event and the Tele Holter device offered by Comarch.

ECG event

Event ECG is a simple device that allows you to record a single lead ECG signal. The patient puts two fingers to the electrodes, and the recording of the examination is displayed live on the screen of a smartphone or tablet connected to the device. The test takes only 60 seconds, and is completely safe and painless. The ECG event is used in Comarch solutions such as Diagnostic Point (available in stationary and mobile versions) and HomeHealth 2.0 (cardiology package).

Devices with Tele Holter mode

Tele Holter is one of the modes offered by the Comarch CardioNow Lite solution, which, thanks to the use of artificial intelligence (AI) algorithms, allows you to detect arrhythmias early enough and inform medical personnel about them. In Comarch’s cardiac portfolio, you will also find CardioVest, used for long-term monitoring of the ECG recording, which is particularly useful in detecting asymptomatic atrial fibrillation. 

Comarch solutions are equipped with Tele Holter mode in contrast to the commonly used mobile cardiac telemetry (MCT) mode. Tele Holter is a monitoring system that allows you to evaluate the entire ECG signal recording in real time regardless of the circumstances. MCT mode, on the other hand, allows only a 30-second fragment of the signal to be sent for analysis every 10 minutes or when an anomaly occurs, using a mobile phone system2.

It is worth remembering that more frequent monitoring of the ECG signal increases the chances of detecting atrial fibrillation before the onset of serious complications such as stroke, heart failure and death.

If you want to learn more about Comarch telemedicine solutions, including those in the field of cardiology, we encourage you to contact our consultant via this dedicated form.

Authors:
Joanna Jędrzejczyk-Spaho, Doctor of Medical Science; Jakub Flis; Katarzyna Strzebońska

Sources:

  1. https://ptkardio.pl/wytyczne/40-wytyczne_esc_2020_dotyczace_diagnostyki_i_leczenia_migotania_przedsionkow_opracowane_we_wspolpracy_z_european_association_of_cardiothoracic_surgery_eacts
  2. https://www.dicardiology.com/content/blogs/real-time-vs-post-monitoring-review-approaches-holter-event-recording

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