Real time heart monitoring and technology.

[BobD]

We often get people asking if there is a device which can constantly monitor heart rhythm and rate other than holter monitors which of course only last as long as your doctor asked for.

Since Holter monitors usually ensure that no AF will occur this make them pretty well useless.

At HRC Patients Day today we learned of new technology coming along which may change this. Artificial Intelligence (AI) allied to some modified existing technology may eventually enable real time long term monitoring without the need for surgical intervention of the sort needed for implantable loop recorders. Experiments using green light tech currently used in blood oxygen sensors has promise once the algorythms and software are sorted but don't get too excited as it may still be some time before it becomes available mainstream.

A South Korean company were also exhibiting a wearable device in the form of a ring which connected to a mobile phone app producing a trace but from my observations this was currently not recognisable to the average person. I had some difficulty discussing the project due to "language incompatibility" (and probably my deafness) and am not sure if the trace was continuous or like kardia of short duration but gather that it is not yet available to market but would likely be at least £350 or more if it succeeds in passing all tests. What it did show me is that before long we should be seeing some of these developments filter through which may well benefit future generations.

Bob

[Buffafly]

I have a cheap oriental watch/fitness tracker which monitors your HR continuously and will produce an extended recording of your HR using a separate app, so I can see how this might be developed. It seems to 'wake up' when something out of the ordinary happens so I have recordings of fast or slow HR which I didn't purposely record though I m not at all sure how accurate it is.

[CDreamer]

I spoke to them last year & this year Bob - Korean company - they are still seeking European approval as a medical device - which is obviously taking time - but my understanding was it will be continuous monitoring - completely different tech to the green light tech - it has rechargeable batteries which last 2 days before needing recharging.

[BobD Volunteer in reply to CDreamer]

Yes I got the continuous bit and I suspect it is similar tech to kardia from what little I could understand. The trace she showed me looked nothing like an ECG so more work on the algorythms I think.

[ling]

"Since Holter monitors usually ensure that no AF will occur "

Hi Bob, sorry but how do holter monitors ensure that no AF will occur?

We were told at the heart clinic that the holter would capture any AF.

Thank you

[Hidden in reply to ling]

Sounds like Bob’s wry sense of humour to me!

Many of us have had a 24 hour monitor and not had an episode during that time, then wham! It comes back a few hours, days, weeks, months later when you are not being monitored. I was ‘lucky’ to have an episode of fast AF lasting 6 hours which made me feel ill enough to go to A&E where it was captured on ECG I was still symptomatic after this and had a normal echo and normal 24hour Holter i.e. no AF in that 24 hours.

Some folk on here have had several Holter and each time ‘failed’ to have an episode leading to delays in diagnosis/treatment.

Advances in monitoring, such as Bob is describing, would be a blessing to anyone struggling to get a diagnosis because their heart doesn’t go into AF on monitoring day.

Pat x

[BobD Volunteer in reply to ling]

If you have ever waited months for one you will know that your heart will behave perfectly while you are wearing it. Your AF will return about five minutes after you take it back. This is known as Sodts Law after Professor Heinrich Sodt (1847-1923_) of Leipzig University who discovered that if something could go wrong it would.

[Hidden in reply to BobD]

Bob is totally correct. I was having flutters and palpitations for weeks running up to having a 24 hour holter monitor, then 24 hours of NSR whilst wearing it with not a single bump out of place.

Obviously the flutters started again shortly after I removed the device.

[lovetogarden]

Interesting developments! Great to hear about these research projects. I recently heard a podcast episode - medscape.com/viewarticle/91... - that mentioned some developments using AI to assess EKGs for AF. The podcast notes page linked to this article. Artificial Intelligence Detects 'Hidden' AFib During Normal Sinus Rhythm medscape.com/viewarticle/91...

[Hidden]

Congratulations on your award Bob.

Thanks for the technology update, sounds promising.

Pat x

[c2low]

Get apple watch series 4 or 5. Near continuously heart rate monitoring. Also capable of ECG measurement when activated.

[BobD Volunteer in reply to c2low]

Not autonomous though as you say. That is the gold standard we are searching for.

[Janelr in reply to c2low]

I have the series 2 and it often tells me I have af (as if I I didn’t know lol ) and tells me if my heartrate is high or too low , I am hoping Santa gets me the 5.

[john-boy-92]

I have a Polar Vantage V heart rate monitor that uses green LEDs to monitor heart rate and it can be downloaded to the Polar Flow app to show heart rate over time. I can also use it to monitor continuously over 24 hours. That's interesting as it shows my heart rate getting down to the low 40s whilst I'm asleep, and how well I sleep. It seems to be accurate up to 120, but above that I use a Polar H10 chest strap with the Vantage V. The Vantage V and H10 data sheets state that they can monitor up to 240bpm with quite a narrow tolerance. I've seen 190+ bpm during overshoot whilst on the rowing machine. That kit is more for runners, cyclists and triathletes but it could provide an insight.

[BobD Volunteer in reply to john-boy-92]

Yes but not an ECG which is what we really need. Rate may be interesting for fitness but useless as a diagnostic tool which is what is really needed for many people. That is what we are hoping for in the future. Continuous ECG monitoring and recording at an affordable price in an easy to use non invasive form.

[AFCyclist]

Good to have a brief chat with you yesterday. I hope your recovery continues. Patience is a virtue!

[john-boy-92]

This is about sample time. The Polar HRM uses a high sample rate and easily tracks the rapid changes that I get in atrial flutter. I'm not sure that green LEDs can produce Q and R waves, and do you really need to know that if you are in a non-clinical environment? I have paroxymal atrial fibrillation and flutter - I can flip flop between them - and a Holter device never captures it even in a Spin class. As I've mentioned here before, the only way that worked for me with a detailed analysis of the wave was being wired up to a high speed display and recorder, whilst working through a monitored Bruce Protocol test on a treadmill.

Athletes' post-exercise recovery can be checked by measuring the variability of the r-r interval, but this can only be done by a chest strap, as the green LEDs only measure blood flow not the electrical signals within the heart.

Sample rates (electrical and biopsies) and risk are part of medicine. As per Bob's medical history, I am aware of physical sample rates and risk factors. The cores in my prostate biopsy are "suspicious for cancer" but I don't have any Gleeson numbers and, Finisteride has a very small risk of causing high grade prostate cancer. Sometimes it's just better to get on with life than worry about the CT scan this week, or what my heart is doing.

[lynneangela]

That would be brilliant,

[Roto]

I've used a bog standard polar sports watch with chest strap...theres no mistaking when your in Af...heartrate all over the place...thankfully it's almost a distance memory for me...he says with fingers and toes crossed

[7Helena]

Thank you for the information, Bob. which is very interesting. Obviously a future improvement.