Alivecor KardiaMobile - Negative Review

Hello all,

Just wanted to report on my use of the Alivecor KardiaMobile device over roughly a 2 year period. This is a quick review of the performance, quality, and customer support. Just a quick background on myself, I have a strong Electrical/Computer Engineering background in working with small, embedded devices such as this, and even participated in some open source ECG projects that were out there (though they never could get enough consumer momentum to launch).

Summarized Review

If you are bought into the Apple ecosystem, just get an Apple Watch 4. I found the quality of the KardiaMobile and the customer support to be lacking for the price you pay.

Overview of Operation

The quick and dirty how the system works is the KardiaMobile has two pads you put your opposite thumbs or fingers on, the signal is amplified, sent over an ultrasonic transducer (speaker) to your phone's microphone, where the ultrasonic sound is picked up and turned into an ECG.

Performance

Pros:
Overall, the system seems to work acceptably in the right environment. For the most part it would detect my heart's signal and draw a trace on the phone for 30 sec to 5 min depending how you set it. I used it once to help diagnose my kid had simple dehydration when their heart was racing and I took an ECG to take to the ER with us. By the time we got there, they had re-hydrated and their heart was back to normal. The doc thanked us for having a trace to double check it was normal and just running fast due to water.

Cons:
For some reason, it did not like to work in some rooms of my house or when I was on travel due to some interference or whatever that I could not pin down (I used a audio spectrograph to try to locate errant ultrasonic sounds, but could not). Sometimes the reading was jumpy or it would just decide to stop if your fingers didn't have perfect contact. Having paroxysmal AF, it is hard to have perfect contact with the pads and make sure everything is just right to catch an episode. In addition, since I am trying to catch a run that comes and goes in 10s of seconds, by the time you unlock your phone, bring up the software, get it ready to record, unwrap the sensor, get your fingers on it, the episode sometimes is gone (more on this later).

Don't forget you also have to pay $10/mo to have the ability to save your readings, else you have to go through several long menus to email a PDF to yourself. Difficult if you are trying to pull together a bunch of readings in a row.

The ultrasonic data transfer drives the kids in my house insane. When I use it, it turns on and they all start complaining how it hurts their ears.

Quality

Pros:
System is small and fits nicely in your pocket / back of phone (as they advertise on their front page) or carry bag.

Cons:
The system is not very rugged. After carrying it about once a week in a small protective case in my backpack for a year, it developed a significant problem. The system would stay on constantly without touching it, emitting a repetitive ultrasonic clicking sound. Not only did it drive my kids nuts to just have it in the house now (not just using it), the readings became erratic. I changed the batteries several times, went through the trouble shooting and called customer support.

Customer Support

Pros:
Customer support was prompt and patient.

Cons:
After a several emails and chats, they came to the conclusion my system is broken. For babying it, it did not take much for it to break. They offered 20% off to buy a new one. One thing that made me think that even though I don't subscribe to their system, the tech was able to read off the number of readings I did, the frequency of use, some results, etc. I really do not want another company having my private data.

Summary

The system was out of warranty, so I was told to buy one if I want to keep using their products. In my opinion, the system is very fragile compared to how they advertise to bring it everywhere with you. In addition, getting it to take a reading takes 15 to 30 seconds to get it up and running with possible spotty readings (due to not being able to get everything perfectly setup), which could be too long for someone like me trying to catch an errant run. For the low cost of components (read that as cost, not quality) that are inside (Video of KardiaMobile Teardown), and charging $10/mo on top of it, you would think they would want to keep customers using their systems by offering better discounts. For me, I am not going to spend another $100 for something that may last a year. I will be getting an Apple Watch with a backup ECG system I have been using from eBay that doesn't connect to the internet or share my private data with a company that I do not trust.

I wonder if the version of the Kardia I have is different from yours as to this point I haven't had any real issues other than an occasional problem with recording but this only happens at work. I also just carry it around in my pocket with my keys and change uncovered. I work in a control room with bunch of monitors and electronics but even still it usually works.

Also data transfer is done from a file directly on my phone so there is no noise. It is true that it does cost $10 a month if you want to store data beyond a singe recording. However this service can be started or stopped at any given time and you can use your HSA or FSA card to pay for it.



Edited 1 time(s). Last edit at 04/02/2019 03:01AM by rocketritch.

Quote
Fibbin AFib
[Sometimes the reading was jumpy or it would just decide to stop if your fingers didn't have perfect contact.

I got my first device in Feb 2014. It did fail in 2017 (after banging around in my computer case, I wasn't careful with it) and got a replacement off eBay for a modest amount. Since I've had it so long, I'm grandfathered from having to pay the monthly fee. Also got one for my son-in-law in December of 2016 and his continues to work well. As to the contact. I always wet the contacts before I use them (in my case I lick them, just like I have for 14 years with my Polar HR monitor straps). I can get good connections when I do as suggested and hold the device between the thumb and forefinger of each hand. However, I like more of a Lead II presentation as it accentuates the p wave. For this, I hold the right contact between my thumb and forefinger and put the left contact on my left abdomen, above my left hip. My belly breathing can cause movement and some artefact. So can the cat, if he is purring in my lap...

Though I have infrequent episodes (and I really can tell with my finger on my radial pulse), I take a reading almost every morning to use in case I ever need to be cardioverted and they want proof as to when the episode started. I've yet to need it for this purpose. I've also used camera pulse wave apps to visually see afib. One that I used for years no longer supports the latest iOS Apple operating system. I now use <[itunes.apple.com] . It turns out that the you can see the variability in the pulse waveform amplitude in addition to the rate (peak to peak distance) in afib.



Edited 1 time(s). Last edit at 04/01/2019 10:34PM by GeorgeN.

I've had one since 2014 and replaced it once because I left it in a pants a pocket that went through the wash. Can't expect any electronic device to survive that. Sorry you've had quality problems but that doesn't fit my experience. It spent years in my wallet being sat on and getting dropped and banged around without problem. It is sensitive to powerful electrical fields, especially things like large electric motors (refrigerators, air conditioners, etc), but virtually any device measuring microvolts is going to be.

I think the most important aspect of a side-by-side comparison would be their accuracy in recordings and ability to detect abnormal rhythms. That's a much more difficult comparison to do and do right.

Thank you Fibbin AFib for the excellent review on KardiaMobile! Have you seen and/or reviewed the smart phone app "Photo Afib Detector"? LasVegas-Roy

I've had mine since late 2016 and am also grandfathered in not having to pay the 10/mo. I've had no issues at all over the last few years although I keep it in a drawer so it doesn't get beaten up. From everything I've read it gets better reviews for accuracy than the Apple Watch, but don't have any direct experience. I would recommend it 100%.

I also blew one up last year. Of course I carry it in the snap-on holder on the back of my iPhone that goes with me running every day in an arm-band. So after 3 years of Southeastern US mid-summer "swamp sweat" being poured all over it I'm surprised it lasted as long as it did!

The weak spot, in my opinion, is the ultrasonic link to the mobile device. Bluetooth would be much better from a signal integrity standpoint, but I can understand why they didn't choose that. BT sucks as far as useability goes. I could imagine my 72-year-old dad trying to get that to work when it doesn't want to. He'd be on the phone for hours with customer support and by day's end the Kardia would be in the trash.

I'm also grandfathered on the $10/month thing. If I weren't I'd be upset about that, too.

Quote
wolfpack

I'm also grandfathered on the $10/month thing. If I weren't I'd be upset about that, too.

I have never heard of grandfathered before, what does it mean.
Are you happy or unhappy to pay $10.00 a month.
or Do you now have to pay $10.00 a month??

Quote
colindo


I'm also grandfathered on the $10/month thing. If I weren't I'd be upset about that, too.

I have never heard of grandfathered before, what does it mean.
Are you happy or unhappy to pay $10.00 a month.
or Do you now have to pay $10.00 a month??

Initially, they did not charge for the full service in their app. People who signed up prior to the date they started charging are exempt from paying (grandfathered). I'm not sure the date, was a year or two ago.

George

My Kardia also started making the ultrasonic clicking noise (for no apparent reason) - my kids heard it before I did. I called customer support and was told that that sound meant it needed a new battery... I was somewhat skeptical, as I'd had it only 6 months or so and the battery life claims are much longer (1-2 years of normal use), but I bought a new battery and swapped it anyway. Didn't fix the problem, so I had to get back in touch with them. Since I was within the warranty period, they sent me a new device and had me mail back the old one.

Just confirming that you're not the only one who has had the issue.

After the first 4 months or so of using it, though, I didn't find it all that helpful as by then I'd learned to monitor my symptoms accurately by "feel." I definitely have canceled the premium service, as I can email the PDFs to archive them.

Quote
colindo
I have never heard of grandfathered before, what does it mean.

It’s actually a term with a horrible history and maybe we shouldn’t use it. It stems from disenfranchisement of black citizens in the American South. Basically, post Civil War, southern states enacted legislation that predicated the right to vote based on whether or not one’s biological grandfather enjoyed the same right. Which applied to exactly zero freed men at the time, and was meant to continue the disenfranchisement in perpetuity. Shame.

Nonetheless, it’s worked it’s way into the lexicon and is now meant to imply that the old rules apply to some but not others.

Sorry if that gave anyone arrhythmia.

@wolfpack - Fascinating info I didn't know.

Regarding the Kardia, I think requiring a monthly subscription to save more than one recording was a huge mistake for Kardia. It's the device's biggest flaw. The app stores data on your device, not their servers, so it costs them nothing whatsoever to save as many as you want. The few people who will sign up for that service won't keep paying it for long, and it will keep a lot of people from buying it. Stupid move on their part.

Thanks George and wolfpack for that explanation.

Fascinating Fibbin and Wolfpack: I had no idea that the Kardia worked via ultrasonic link! I have
been routinely using one for months (linking to a Samsung Tab A, which is NOT on their compatible list!).
No problems at all. I am [perhaps] too old to hear the ultrasound. I just assumed that it transmitted via Blue tooth,
as is typical these days. Sure enough I switched off my tablet's BT and the Kardia still functions!
Is there some place I could read up on this method (its limitations, how wide spread, etc) is.
What frequency sound, range, etc.?

I, for one, can't hear a thing when I'm using it. The ultrasonic link is susceptible to background noise. I can't get a good reading anywhere but a quiet room. Wind, which is white noise, and bird chirps, which are akin to a wideband frequency modulation, will drive mine nuts. I don't know that you blame the Kardia for that or the iPhone that I use. Could be either, no way to tell unless I buy a new phone which I'm not going to do.

Just know that to get the best reading possible from the Kardia you should go shut yourself in a quiet room for a minute while you use it.

Quote
wolfpack
I, for one, can't hear a thing when I'm using it. The ultrasonic link is susceptible to background noise. I can't get a good reading anywhere but a quiet room. Wind, which is white noise, and bird chirps, which are akin to a wideband frequency modulation, will drive mine nuts. I don't know that you blame the Kardia for that or the iPhone that I use. Could be either, no way to tell unless I buy a new phone which I'm not going to do.

I'm going to say it's the iPhone. I once taped my Kardia to my chest and went for a bike ride. There was steady wind noise, of course, plus the noise of passing vehicles, and it worked just fine. I had to hold the phone right next to it, so it really wasn't very useful that way, but it did work. What I always found more of a problem than noise was electrical noise, in particular things with large electric motors like refrigerators.

Can you get good tracings in such conditions ? With my HealForce, I've to stop moving while recording, even wen using the lead wires.

In addition to the very good advice that Carey and others have noted above, it’s important to be relaxed physically and sitting calmly with forearms resting on a table or lap for a few minutes ... if you are anxious and breathing heavy or holding your breath then learning to engage in 5 minutes a of gentle rhythmic breathing (i.e. I’m Not talking about doing Atheletic-style yogic pranayama (breathing exercises). But just do this relaxed rhythmic in and out breathing just prior to recording a 30 second EKG.

Also, make sure that your index fingers connecting to the two metal electrodes are moistened and that you have only a moderately firm
grip on the KARDIA mobile device during recording ... but DO NOT squeeze your fingers on the electrodes with a strong anaconda-like grip!! Doing so will almost always create added electrical noise and can skew the waveform significantly as well.

The ole’ “moderation in all things” advice applies to deliberately taking it easy when recording KARDIA EKG strips, which can be challenging to remember to do, and to pull off, for those new to the device and who might be anxious enough as it is to begin with from the overall AFIB.

A little deliberate practice makes almost perfect when following all the good advice above.

Cheers!
Shannon

Yeah, the bicycle thing was just an experiment. The movement produced too much noise for the readings to be useable. In general you can't get a good reading from any ECG device while you're moving unless you happen to have an exercise stress test ECG.

I do get reasonably artefact free readings from a Polar H10 strap with the Heart Rate Variability Logger app on my iPhone. The H10 & app only record rr time. However I've looked at rr vs time or transformed the rr ms into heart rate vs time (tachogram) for over 14 years now. You don't get full ECG reading, but you can see a lot (PVC's, PAC's, afib, apnea). Actually for long (8 or more hour\) readings, I like the tachogram better. t export the rr times into a .txt file, put that into a Polar HRM file and look at it in using the Polar Pro Trainer software <[support.polar.com] The Polar software will quickly window the data into whatever time width you want on the X axis. I usually use 20 minutes. I can look at a many hour file very quickly and see anomalies. Doing this, I saw apnea patterns in the tachogram which cleaned up when I taped my mouth shut at night, forcing me to breathe through my nose.