24 hour single lead ECG device

Re: 24 hour single lead ECG device

TomSeest — Sun, 30 Sep 2018 17:14:47 +0000

The SkepticalCardiologist, who happens to be my Cardiologist, had asked me to write up a blog post about 3 weeks ago, before I had my new heart challenge with Ventricular Tachycardia. I took the opportunity to write this up for him yesterday, in a new attempt to destress:

[theskepticalcardiologist.com]

Re: 24 hour single lead ECG device

GeorgeN — Sat, 29 Sep 2018 22:43:56 +0000

Quote
Carey
it's not available in the US. You can only buy it in Canada, Australia and Europe.

True, but I checked eBay and Amazon and it is available from sellers in the UK and Germany. I asked Tom and he told me he bought his from out of the country.

Re: 24 hour single lead ECG device

Carey — Sat, 29 Sep 2018 22:37:13 +0000

If it can obtain high quality ECGs while running, biking, etc, that's impressive. They must have implemented the same filters that stress test ECGs use. I took a look at their web site, and unfortunately it has two big drawbacks for me. First, it doesn't support Android phones, and second, it's not available in the US. You can only buy it in Canada, Australia and Europe.

Re: 24 hour single lead ECG device

Pompon — Sat, 29 Sep 2018 17:31:33 +0000

Take your time. Your health first !

Re: 24 hour single lead ECG device

TomSeest — Sat, 29 Sep 2018 16:02:30 +0000

Depending how I feel, I may try it for a brief ride this weekend. With V-Tack in my near past, I'm trying to keep stress low. But, it probably wouldn't hurt to ride a quarter of a mile at slow cadence.

Re: 24 hour single lead ECG device

Pompon — Sat, 29 Sep 2018 15:53:27 +0000

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TomSeest
That is the way it is designed. I have not tried it that way yet though. And, now, I probably won't for another week or two.

You do get some noice in the ECG when you first change from sitting to standing, but it is designed to be worn while running or bicycling.

It's interesting. I can use my monitor with electrodes and lead wires while bicycling, but I've to stop and stand still to record something usable. I'd like to know if your device does better. Thanks to let me know ASAP.

Re: 24 hour single lead ECG device

TomSeest — Sat, 29 Sep 2018 15:50:38 +0000

It seems fine while I'm in motion. It's just when I make drastic changes in position, like standing up abruptly.

Re: 24 hour single lead ECG device

TomSeest — Sat, 29 Sep 2018 15:33:59 +0000

That is the way it is designed. I have not tried it that way yet though. And, now, I probably won't for another week or two.

You do get some noisy data in the ECG when you first change from sitting to standing, but it is designed to be worn while running or bicycling.

Re: 24 hour single lead ECG device

Carey — Sat, 29 Sep 2018 15:12:51 +0000

Quote
Pompon
Do you think you might get good tracings with this device while exercising or moving?

Doubt it. Even hospital monitors don't handle vigorous movement well. I managed to set off the v-tach alarm just thrashing around in the bed trying to rearrange the sheets.

Re: 24 hour single lead ECG device

Pompon — Sat, 29 Sep 2018 08:36:40 +0000

Do you think you might get good tracings with this device while exercising or moving?

Re: 24 hour single lead ECG device

TomSeest — Sat, 29 Sep 2018 02:02:40 +0000

Thanks. If I had better eyes, and was paying closer attention, I would have realized it earlier in the day. But, it seemed pretty obvious from the trace after seeing it later in the day...

Re: 24 hour single lead ECG device

wolfpack — Sat, 29 Sep 2018 01:53:33 +0000

That rhythm was v-tach as sure as the sun rises. Yikes! Glad you’re OK.

Re: 24 hour single lead ECG device

Joe — Fri, 28 Sep 2018 22:40:49 +0000

Thank you, Tom! Great insight!
Best wishes!

Re: 24 hour single lead ECG device

TomSeest — Fri, 28 Sep 2018 19:56:06 +0000

I apologize for my tardiness in posting updates to this site. I am well acquainted with George through Facebook, and he has my permissions to share anything that he wants. I feel bad that I haven't posted in detail before, but I generally work 80 hours per week, and have limited time to post in any social platform. But, I will try to add a few helpful details here.

The QuardioCore is an excellent device, but does not provide any interpretation of the ECG. The App that comes with it can be buggy at times, but I generally like the device and strap. However, if you use the ECG feature, you have to be able to interpret single lead ECG patterns. I originally bought the device, as I plan to return to long distance bicycle touring and wanted to be aware of rhythm disturbances. While I'm not an expert on interpreting ECG's, I can generally identify noise artifacts, etc. To save time, I'm posting part of a post from my Facebook wall, which will be to simplistic for many of you that are familiar with rhythm disturbances.

I was wearing this strap while sitting at my desk on Wednesday morning (9-18-2018), and felt instantly bad at about 8:58 AM. I had the app open at the time on my phone, and glanced over. Unlike most people that have heart rhythm problems, I rarely experience pain or other symptoms. In this case, I was sitting and felt bad. The best way to describe it is that it felt like I had a bunch of gerbils running on a wheel really fast in the area of my lower heart. I knew something was wrong, but having had heart rhythm problems before, wasn’t alarmed. From a casual glance at the screen, I figured I was having an episode of Atrial Flutter which isn’t uncommon for someone that has rhythm disturbances. My heart went back to normal rhythm in 18 seconds, so I made note of the time (first time I’ve been out of rhythm in 7 months), and continued working.
Later on, after I went home, I pulled up the App for the device, scrolled back to that point in time, and realized that I had made a significant error in judgment. While I’m no expert medical professional, or certified in any way, I spent 14 months investigating heart rhythm disturbances, and quickly identified the heart event as some form of Ventricular Tachycardia. I actually had another 4 second event about 15 minutes later, that was identical in nature. At that point, I contacted my wife and asked her to come home from Chicago. While most forms of heart rhythm disturbances are not dangerous, I knew that any disturbances in the Ventricles (bottom chambers of the heart), and not in the Atrium (top chambers of the heart), are far more dangerous as they can more easily lead to things like cardiac arrest, or what is commonly known as a heart attack.

I contacted my cardiologist via phone and he kindly returned my call. I had made him aware that I had received this ECG device three weeks ago during an email exchange, so he was aware that I had the monitor. I quickly sent him pictures of both events via text message and he agreed that it was probably Ventricular Tachycardia of some form, and agreed that this could be far more serious than what I had before. While he advised me to go to the hospital in Springfield, Illinois which is geographically closer than his hospital in St. Lukes, he agreed to admit me to his hospital if I wanted to go there instead. After discussing it with my wife, we felt it would be better to travel back to the hospital where he was, as he has the details for my past history. While this may seem risky (Martha drove), we felt it was the right thing to do. The reality is that we never know when our last heart beat will happen, so it is a risk we live with every day.

Upon admission to the hospital, they put on their more sophisticated heart monitor (12 lead ECG), put in an IV port, drew a bunch of tubes of blood for lab work, and told me to sleep. Since Ventricular Tachycardia carries a risk of cardiac arrest, they wanted to test me 3 times for Troponin levels. For non-medical people, Troponin is a protein molecule that gets released in great quantities during a heart attack. In my case, they only did the blood test twice as it become evident that the heart muscle seemed to be undamaged. In any case, sleep was hard to come by during the night, but the nursing staff was excellent, and we both slept as we could.

My cardiologist arrived Thursday morning and woke me up, and asked me if it was okay with me to discuss my case with his four residents and have them attend with me. After assembling them, I showed them my ECG strap, the resulting ECG strips, and began answering their questions. After discussing the various options with the residents, along with the cardiologist, we decided that the first step would be to have a Transthoracic Echocardiogram (TTE), as I wanted to be sure that my heart failure was still absent after 7 months. With heart failure, the chambers of the heart can change shape, that can cause both Atrial and Ventricle heart rhythm disturbances. While I was fairly sure that my heart failure had not returned, based on blood lab work I had run two weeks ago, the TTE is a nice, non-invasive procedure that allows the cardiologist to determine the ability of the heart to function. The typical human heart functions at about 55 to 75 percent meaning that the 55 to 75 percent of the blood that enters the heart gets pumped through and out the other side. With heart failure, it means that your heat can’t efficiently pump the blood through the chambers of the heart. Last September, my heart was operating at 27 percent and had improved to 49 percent in January. But, I had not had it measured since then. The goods news from yesterday, is that my heart looked great and that it was operating at 66 percent. While the TTE can reveal simple things like heart muscle damage, etc, it’s only a means of eliminating what isn’t causing the heart rhythm disturbance.

I then met with an Electrophysiologist. Heart doctors are generally divided into two main categories, although they have many specialties within these categories. A Cardiologist is typically labeled as a plumber (not because they don’t tighten their belts), because they typically deal with problems relating to the mechanical movement of blood flow. This would be things like blockages, heart failure, etc. An Electrophysiologist is thought of as an electrician, as they typically deal with problems relating to the electrical signal that charges and discharges making the heart muscle pump. The Electrophysiologist was nice and indicated that he and the cardiologist both believe that the next step is to undergo a Left Heart Catheterization. Based on the ECG of the events that I recorded, the believe that the irregular rhythm originated out of the left ventricle, and would like to go in and look around at the heart on the inside. While this procedure can have complications, it is considered minimally invasive compared to other procedures, and allows the doctors to get a birds eye view of the heart from the inside. While they don’t think it is likely, there is a possibility that I have some blockages on the inside that could cause the abnormal rhythm. Like anything else, this would be additional information, and allow us to make better treatment choices.
The Electrophysiologist really thinks that the cause could just be something as simple as stress, as I lead a fairly stressful life at times. We are a household in transition right now (technically, an RV-Hold). While I’m never really aware of stress, I tend to over do things. And, I’ve probably done that. But, it’s also probably safest to make sure that I don’t have any blockages or damage in the heart muscle or valves that would be only really evident from the inside.

Since I am a self pay patient, we want to be cognizant of the costs to acquire this additional information. In a hospital setting, your time is their money. The longer you stay there, the more it costs, and I don’t believe that someone else should pay my direct costs involuntarily. So, I made the decision last night to check out of the hospital against medical advise. While the doctors all agreed that there is a risk of having another event, and that it could be fatal, I’ve lived with that risk for 52 years. From a logical perspective, I may be wrong and I may have another incident, but I’m hopeful that we’ll get the cost information to have the procedure done on an outpatient basis in the next couple of weeks.

While I’m sure many people would disagree with my decision, both my wife and I are comfortable with it, as I have been living with the seriousness of heart disease for a couple of years. I don’t want anyone to be either alarmed or offended by my actions, but we want to have more information before we proceed.

I hope this recap helps those here, and I will try to provide a more detailed post in the future regarding my past experiences with Heart Failure and Atrial Fibrillation With Rapid Ventricular Response.

I appreciate George posting this here, as I find it as a valuable tool that may benefit others. My EP and my Cardiologist spent at least 15 minutes reviewing the detailed ECG in the app and were impressed. I also have the Kardia Alivecor device, but it requires that I trigger a reading during or before an event to capture it. IN this case, I would have missed recording both events.

Thank you.

Re: 24 hour single lead ECG device

Carey — Fri, 28 Sep 2018 16:38:56 +0000

Quote
GeorgeN
I assume this would make you happier:

LOL.... Yeah, that's a little more upbeat.

Re: 24 hour single lead ECG device

Pompon — Fri, 28 Sep 2018 15:04:13 +0000

There are some single lead ECG devices that do continuous recordings (at least for 8-10h, I think) as well as 30 sec. recordings. The issue with those devices is you must be still to avoid numerous artifacts.
Professional holter ECG monitors do better, of course.
I don't know for this system but, considering its high price, I hope it has algorythms allowing good tracings even when the patient is moving.

Re: 24 hour single lead ECG device

GeorgeN — Fri, 28 Sep 2018 13:50:24 +0000

Quote
Carey
I hope the image you posted above isn't a real recording from him.

I assume this would make you happier:

Points up the utility of the device. " Had one 20 second episode yesterday morning, and one 4 second episode yesterday afternoon" "When I went into VTach, I felt fine but could feel the gerbils starting to run at a high speed. Felt fine when it converted out. No pain. Thought it was just Flutter until I got to check out the ECG last night and realized I had more of a problem."

He would not have known of this issue without having captured the episode. Obviously why he's getting checked out by cardios & EP's.

Re: 24 hour single lead ECG device

Carey — Fri, 28 Sep 2018 12:56:45 +0000

I hope the image you posted above isn't a real recording from him.

24 hour single lead ECG device

GeorgeN — Fri, 28 Sep 2018 12:13:03 +0000

A friend recently posted about his QuardioCore ECG monitor for iPhone <[www.getqardio.com] . This is an ECG chest strap that will monitor your ECG for 24 hours & is connected wirelessly (Bluetooth) to an iPhone. This are not officially available in the US (till it gets FDA approval) but can be had through eBay & Amazon from sellers in Europe in the UK. I didn’t do the price conversion math, but looks like they are being sold in the ~$500 range. This will give you a single lead ECG, just like the Kardia/AliveCor. I’m posting this in case someone has need of longer monitoring. I’m not sure what automatic afib or other arrhythmia detection routines the device has, or if you just get to read the ECG’s yourself. I don’t have personal experience with this device. I can speak to the utility of overnight monitoring, which I’ve done using a heart rate monitor, creating a tachogram (heart rate vs time graph). I bought my first device to do this with in 2005. I described this setup here <[www.afibbers.org] <[www.afibbers.org] Though currently use an app and a chest strap - my device only gives heart rate vs time, but I can "see" a lot of rhythm issues in the tachogram and taught myself to interpret them.

My friend is in the hospital for short high speed tachy runs. He said, “It’s a great device. The EP and Cardiologist and staff have come in to play with it through out the day.” He is an interesting case. He became morbidly obese because of an injury (500 pounds?). In Dec 2016 he got pneumonia. This led to persistent afib and ultimately heart failure and a very low ejection fraction (~27). In Jan, 2017, he started a program of repeated extended fasts (for autophagy, some at least 5-10 days – he’s never told me exactly), intermittent fasting, a very low carb diet and regular 20 mile bike rides. Amazingly in March 2018, he went into normal rhythm and has remained in rhythm with the exception of these two short tachy runs now. His heart failure and low EF resolved. I’ve encouraged him to write up his experience for our site, but he’s yet to do so. I think what he’s done is remarkable. Though still a big man, he’s also lost a lot of weight.

George