Ode to My Favorite Gadget: A Heart ECG at Your Fingertips!
Kathleen Hickey, EdD, FNP-BC, ANP-BC, FAAN, is a nurse practitioner in cardiac electrophysiology, an assistant professor at the Columbia University School of Nursing, and an alumna of the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program. Hickey is president of the International Society of Nurses in Genetics.
As a cardiovascular nurse practitioner, there have been many instances when a patient has reported an intermittent and sporadic racing of the heart, chest pressure or other vague symptom. If I had only an ECG (electrocardiogram) when that was happening, I thought to myself on many occasions.
But as most practitioners know, in the real world such episodes rarely occur while the patient is right in front of them. Rather, symptoms occur when the patient is at home, at work, has just left the provider’s office, or is on vacation!
The widespread use of smart phones has resulted in a plethora of gadgets, gizmos, and associated health care applications—but one I can’t live without is the AliveCor heart recorder and application that is now compatible with the iPhone.
The cardiac recorder is placed on the iPhone in a similar fashion to an external phone case, and a free application is downloaded. Using one’s fingertips or placing the device to the chest, a quick, single-channel ECG can be captured within seconds. This technology has allowed patients to self-capture ECG rhythms from their phones from virtually any place, within seconds of the symptom. Providers can view the ECG information on a password-protected website.
Here’s a real-world example: A patient we will call WK has an extensive cardiovascular history. He was complaining of occasional skips and flops in his chest, usually at around 3 a.m. But these symptoms were sporadic and just never seemed to occur when he was wearing any other external cardiac monitors. As part of my research, I offered him an ECG case he could use on his iPhone to capture an ECG in the setting of such symptoms, should they occur again.
Several months went by then the call came. “I had palpitations last night at 4 a.m. and I used the gizmo to capture an ECG,” he said.
I was then able to log onto the secure server and, within seconds, the mystery was solved. A common irregular arrhythmia known as atrial fibrillation was the culprit in his sleep disturbance and symptoms.
With another quick keystroke, I forwarded the information to his cardiologist for review and future management.
This real-world ECG technology is relatively simple to use. It benefits both patients and providers, and has made capturing an ECG available at one's fingertips.
That’s technology at work!
Read more about RWJF grantees who are harnessing the power of technology to advance a culture of health.