At-home devices for monitoring BP w/ EKG technology

I know Omron and Kardia are just two names of companies providing at-home equipment for monitoring blood pressure and also have built-in EKG technology. I'm curious to know if there is any generally accepted gold standard manufacturer of such equipment?

Kardia is the only consumer-grade EKG device with full FDA approval for detecting afib, so that would be the only "gold standard" device available.

Apple Watch has limited FDA approval. It won't detect above 120 bpm and Apple won't support its use if you have already been diagnosed with afib.

Everything else is hit or miss. There are fairly reliable devices, there's useless junk, and there's everything in between. Personally, if afib is your concern then I would say Kardia is the only reasonable choice.

Thank you! @Carey

I concur with Carey about the Kardia & I've used one since 2014. However, recently, this poster talked about two devices from Wellue that allow longer ECG recording, one for 30 minutes and another for 24 hours. [www.afibbers.org] The 24 hour monitor says it comes with AI software for analysis. I've used a Wellue SpO2 ring for a few years and works, though the device can lose contact with the skin if you roll over on it.

I've used Polar beat to beat recording devices for long duration recording, including overnight, for over 15 years. Even though only beat duration (in milliseconds) is recorded, I can "see" afib, PVC's, PAC's and other patterns. I've found the information helpful in monitoring my heat status. I can analyze the plotted beat to beat data visually pretty quickly. I would not want to analyze long duration ECG's without software. A friend had his own Holter years ago & I borrowed it for a while. The software was key to the usefulness.

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GeorgeN
I concur with Carey about the Kardia & I've used one since 2014. However, recently, this poster talked about two devices from Wellue that allow longer ECG recording, one for 30 minutes and another for 24 hours. [www.afibbers.org] The 24 hour monitor says it comes with AI software for analysis. (...)

I don't know about the Wellue device, but it's apparently in the same league as the HealForce Prince 180B I'm using.

Just a few comments about such devices...

- They have a built-in (colour) screen and can memorize hundreds of short recordings (30s or so), allow reviewing them on the sreen and downloading them on computer. Good software, but the HF one is Windows only.
- There seem to be options among the models (at least for the HF Prince), some coming with lead wires and allowing long time recordings, others 30s recordings only (as well using wires or the built-in electrodes)
- Whatever the length of the recording, one has to remain perfectly still while recording. It's fine while in bed, not so while active. I think "continuous" recording may be useful for those who wonder what can happen to their HR while sleeping.
- 30sec recordings are likely enough for symptomatic patients. Some good tracings "while things happen" are easier to manage than reviewing hours and hours of recordings.

THIS is not new, but an interesting reading, IMO.

I did buy the Visual Beat ECG RECORDER WITH AI ANALYSIS.
For my purposes, trying to analyze PAC frequent over the course of a day, many days in a row: it works great.
First, its a small light device (~3/4-in x 3.7inch) that straddles between two electrode patches that you place diagonally on your left chest.
No one can notice it unless you are wearing a tight shirt. To monitor in real-time, you are just using an app on your phone, and doesn't look like you are using a medical device: very discrete.

Rechargable in about 2 hours for enough charge for 3 days.
It records continuous for 24 hours unless you disconnect it and reconnect- if you do, then you get multiple recordings.
While it records it can also simultaneously connect to smartphone over Bluetooth and show you your current ECG graph delayed by about 4 seconds: this is especially useful for determining if the electrodes are placed well and determining if you are doing an activity that is creating artifacts. (Jumping, some chest exercises, rolling on top of it in bed), Works without artifacts for rigorous walking, exercise bike, use of dumb bells (as long as your shirt isn't binding (your mileage may vary). I can roll all the way on my left side if I am careful not to squash it- the signal gets attenuated a bit but still shows and processes the waves properly. The near real-time ECG is also useful for background monitoring
to get a gross idea of whether you are in a frequent PAC time period or not. The 4 second delay is nice it a way because if you get a chest pain (mine have been gas) it gives you time to look over and see if the ECG is showing something interesting.

Every 24 hours (or sooner if you want), you can unclip the device from the electrodes and connect it with a special dongle to your windows PC to download the data- takes less than one minute- (then you can immediately reconnect the device back to the electrodes). You can then upload your report to the cloud for AI analysis: the AI analysis typically takes less than 10 minutes although the popup says to expect 30 minutes.
Then you get a 6 page report summary statistics and event types and the tool also updates the 900 page pdf ecg strip with markers to every interesting event the AI identifies.

In my case, I could try different experiments to determine if different activities or foods or supplements would change the rate of frequent PACs I was having.
The device helped me get from 12000-16000 PACs for over three weeks (300-800 every hour), down to just 500 yesterday.
In my case, is seems to be glucose related. I was told I was prediabetic many years ago, but knew I could keep my diet from getting too bad that I was fairly sure I was not going to drift up to diabetes- but it seems heart damaging is being done in the prediabetes state.
My conjecture is maybe if I pay attention to eliminating the sources of frequent PACs that I can delay or eliminate the expected march to AFib.

I didn't see any other offering that seemed as complete and was priced the same or lower. I'd be curious what the other ECG under $500 that offer free AI on 24 hour recordings.

Great sleuthing, AsympPACs!!

I've used a glucometer since 2006, just to optimize my metabolism. I've never had PAC volume as you have, but made the assumption that minimizing what I had would be useful, as you stated.. Also optimizing metabolism would optimize overall health.

In this post there is info on Marty Kendall's work. I've found it useful.

Another thing I've found useful is that 15 minutes of Zone 2 exercise after a meal will generally drop blood sugar into optimal fasting range (~80 mg/dL). If I do it after dinner, it sets me up for an optimal morning blood glucose. I use a MAF heart rate to approximate my Zone 2. See this post for more on Z2 & MAF.

Hi GeorgeN,
Thanks for reading and advising!
I actually started thinking about getting a glucometer- but I have had relatively poor and slow skin healing so I'm not inclined to poke myself constantly.
It's conceivable that once my A1c drifts down toward 5.0 that the skin healing will improve.
The PACs are now easy to monitor for, so I'm using them as my canaries in the coal mine.
If the PACs come back while on a diabetic friendly diet, then I will plan to take a deeper dive into blood chemistry and electrolyte balance.
If the PACs stay away, I will likely slowly introduce magnesium glycinate, VitD3 and possibly VitK2.

I've also beefed up my exercise- I still work at a desk full time- but now its a standing desk with an Exerpeutic 400XL Folding Recumbent Bike Magnetic Upright Exercise Bike.
I forgot to mention that the Wellue device also constantly tracks heart rate and gives vibration signals when you are in different settable HR zones.
Exercising at 85-90 bpm did not seem to have good effect- so now typically I am aiming for 100-120.
7 years ago I was training at 150-160 bpm for an hour- hopefully when I get the all clear from the cardiologist, then I can work back toward that.

I have a CAC score in the 800s so "timing" issues are not my only heart concern. I'm getting a cardiac MRI within 2 months.

Thanks again for sharing your experience.

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AsympPACs
Exercising at 85-90 bpm did not seem to have good effect- so now typically I am aiming for 100-120.
7 years ago I was training at 150-160 bpm for an hour- hopefully when I get the all clear from the cardiologist, then I can work back toward that.

I highly recommend listening to these Peter Attia podcasts podcast 1 & podcast 2 with Iñigo San Millán (University of Colorado Health Sciences researcher and head coach of the winning Tour de France teams in 2020 & 2021). It may give you a perspective as to why you would prefer not to have most of your training at the high heart rate. There are mitochondrial density adaptations that occur at the Zone 2 level (as defined by San Millán). Most pros spend at least 80% of their time in Z2 and per San Millán, most recreational athletes spend most of their time at too intense a pace and fail to get this adaptation. Also, over time, this level of activity, with the mitochondrial adaptation, should help your glucose disposal and insulin resistance.

I approximate San Millán's Z2 with Phil Maffetone's MAF heart rate, nominally 180-age, though there are qualifiers. [philmaffetone.com] Ideally by training this way, you should be able to do the same work at a lower heart rate or more work at the same heart rate, over time. Without a monitor, I just use nasal breathing as my limit. My 35 year old afibber son-in-law has been following this approach for quite a while, at my suggestion. He can now do a lot more work (running) at a low heart rate.



Edited 2 time(s). Last edit at 06/09/2022 01:26PM by GeorgeN.

Thanks for the recommendation- listening to it now.

[www.podchaser.com]