Home testing machines

[Shell2023]

I am new to this group and I have family with afib, I have panic and anxiety with rapid heartbeat but was trying to rule out heart issues. I bought a kardiamobile ekg machine and tried it about 10 times and always got unclassified. My husband tried it and he got normal so it didnt appear to be interference or anything like that. next day I tried one more time and got possible afib. I will talk to my doctor about this but wanted to know if the machines seem to be reliable. Is the more expensive 6 a better unit to get, do you have the pay membership to get results reviewed? Is there a better machine for home EKG or heart monitoring

[mjames1]

Yes, the Kardia's are reliable and produce medical grade ekg's, arguably clearer than you get from a holter monitor. Forget the machine interpretation (Kardia calls them "determinations") like "unclassified". It can mean different things.

The important thing is the ekg itself. Email it to an ep for interpretation, not a GP, not a cardiologist, but an ep. They know how to read ekg's better than Kardia's machine determinations. . You should be able to email them to a Kardia cardiologist for quick turnaround interpretation as well, but I'd still run them by an ep.

As to the 6L, it will give the ep more information especially because it can help differentiate better say atach from aflutter. And since Kardia is not currently licensed to determine aflutter, there is a decent chance Kardia's "unclassified" actually is aflutter. So the 6L might be a good investment in your case.

I have all the various Kardia models. Takes a lot of guesswork out of things if you understand their strengths and weaknesses. And btw even the ekg machine at the doctor's office makes wrong calls and that's why a good ep ignores what the machine says and relies on the ekg itself and their training. A GP on the other hand, might take the machine interpretation at face value. That's why they are not very useful reading ekg's, except for the very obvious ones.

Jim

[kitenski]

I returned my Kardia as even paying for their advanced determinations kept giving me unclassified results. After some searching and discussions on here I got a Wellue device with AI reporting and that has been spot on, not had an unclassified reading at all.

Either their getwellue.com/products/port... or getwellue.com/products/duoe... are superior to the Kardia in my experience.

I was going thru a very bad spell and also bought their 24 hour monitoring device for more in depth analysis. getwellue.com/products/hear...

[mjames1 in reply to kitenski]

The Kardia EKG is just as accurate as Wellue's and is certified medical grade which I am not sure Wellue is.

The fact that you get classified or unclassified readings should not be a determinant. It's only the EKG itself that matters and the interpretation of a skilled EP.

So unless the EKG analysis is confirmed by an EP, I would not completely trust Wellues interpretation any more then I woukd trust Kardia's.

This is not a criticism of Wellue, just pointing out that all machine interpretations have limitations and just because one brand makes a call while the other ssys "unclassified" doesn't mean the one that makes the call is better.

Even with a 12 lead office machine.A good EP does not look at the machine interpretation, but does their own interpretation.

Jim

[kitenski in reply to mjames1]

Sorry but I disagree 100%, in the UK we do not have the ability to have ECGs confirmed on demand by an EP.

So if I am paying out my own money for a device (and then more again for advanced analysis with Kardia) an answer of unclassified is unacceptable to me. I had PVCs/PACS/Ecoptics/Bigeminy and A Fib that the kardia reported as unclassified that the Wellue picked up on.

[mjames1 in reply to kitenski]

And how can you be sure that the Wellue's machine interpretation is accurate without a trained human reviewing the ekg? My guess is that if Wellue applied for medical certification like Kardia, it would not be able to make those determinations.

Jim

[kitenski in reply to mjames1]

Simply by looking at the ECG and confirming it was correct based on my knowledge and the feelings I get from having had afib for four years. Finally having some of the ecgs validated as well by medical professionals via email and forum posts.

Compare that to Kardia where I paid for the extra diagnosis that failed and then used their trained eye service to review an ecg which told me exactly what the wellue AI system did.

That’s exactly how machine learning and AI work, it gets taught a model, if it’s unsure a human assists the learning and it improves its results in an iterative fashion.

Fine if you don’t like it, I’ve used both and as I said sent the Kardia back.

[mjames1 in reply to kitenski]

If it's simply by looking at the EKG and prior ep evaluations, I can do that with my Kardia as well. For example, my atrial flutter is always "unclassified" but I know it's aflutter and not a fib, or perhaps atach which my six lead cardio can help differentiate, but I don't see how Wellue can make a definitive call on a flutter versus a atach with only a single lead? Even an EP can't do that.

Here is an excellent review of Wellue. And again I am not against wellue. I think it's an excellent device as long as you understand it's limitations and that it has no medical certification like Kardia has.

theskepticalcardiologist.co...

"...The AI interpretation is most reliable if it does not discover any abnormality.  But it is subject to errors due to baseline drift and environmental electrical noise.  If the electrodes are not in excellent contact with the skin, there will also be many spiky-looking artifacts and bizarre-looking waveforms.  On occasion, the AI will mistake those for real extra beats or aberrant rhythms. For example, some artifacts in my records were mistaken variably for the very serious anomaly of ventricular tachycardia and also for couplets (adjacent pairs) of both premature atrial and premature ventricular contractions.  

It’s important to note that AI analysis is not a substitute for a professional medical diagnosis. Any significant abnormalities in the ECG recording should be evaluated by a healthcare professional...,"

[kitenski in reply to mjames1]

My problem with Kardia is that it just didn't work for me, despite paying for Advanced Determinations via Kardiacare.

I'm glad it works for you. The Kardiacare package supposedly covers (in their words)

6 FDA-cleared ECG determinations, including AFib, Bradycardia, Tachycardia, PVCs, and more.

When I queried why it was missing things I started to get told of various caveats, which appear to be severe limitations IMHO and something people need to be aware of. To be fair to kardia they did refund me.

If something is detected in you EKGS that falls out of the algorithms determined by Kardia, it may give an Instant Analysis of "Unclassified". We do recommend that you share ANY concerning EKGs with your Doctor for further assessment and other arrhythmias would be detected in the EKG by a medical professional.

In order for the Kardia app to read the Advanced Determinations for PACs, there have to be 4 or more PACs present in the first 30 seconds of the EKG for the result screen to show Sinus Rhythm with PACs. For the Advanced Determinations to read Sinus Rhythm with PVCs, there has to be 2 or more PVCs within that 30-second recording.

In reading your Clinician Review, it says that there was only a single PAC that was detected within the 30-second recording. That is why your EKG came back as Unclassified. The single PAC was not picked up because there was only one. Now if there had been 4 or more it would have read PACs.

[mjames1 in reply to kitenski]

One day AI may be better at reading an EKG then an EP. Unfortunately, that day is not here yet and certainly Wellue's AI is no match for a good EP. And Wellue's single Lead is no match for kardi's 6 lead in differentiating certain arrythmia's like aflutter vs atach.

Just because Wellue will make a determination while Kardia will call it unclassified, doesn't mean it's making the right determination.

I'm glad it works for you and you can have the last word but I hope anyone reading this will never rely on an AI analysis of an ekg vs an ep's analysis. These devices are a great adjunct to an EP. But to rely on them solely can potentially do a lot more harm than good.

Jim

[Shell2023 in reply to mjames1]

also, have you heard of the qualy appt that supposedly reads unlimited ekgs?

[mjames1 in reply to Shell2023]

No, but thanks for bringing it to my attention. From a very quick look, it seems like it may fill a gap between personal device AI readings and those by your ep. However, the human readers are neither cardiologists or ep's, so while I'm sure they can tell PACs from afib, I would be somewhat cautious with more complex determinations, such as differentiating aflutter from atach, especially if the source is only a single lead like Apple Watch. In fact, good ep's themselves have problems doing that and I've gotten different interpretations on the same ekg by different ep's. But again, an app like this may fill a gap if used wisely.

Jim

[Ppiman]

I used to get Unclassified when my heart rate was over 100bpm and there were many ectopic beats, rather than AF. I recently changed to a different make (Wellue 24-hour AI) as I felt annoyed at having to spend each month as I found I needed the Kardia "Advanced Determinations".

Steve

[MarkS]

I got quite a lot of unclassified on my new Kardia recently. When I saw the EP recently he looked at the 6 lead results and said it was AF. This is slow AF- around 70bpm and looked quite regular to myself and my wife (a retired GP), but the p-wave was missing. I am still just as active as I was but I do have a 24 hr ECG on at the moment. I've just finished an aerobics class and the stickers stayed on, much to my surprise. The EP says that'll be good instead of an exercise ECG. I also had the old Kardia results from 2022 before it stopped working and he said those showed AF as well, much to my surprise!

[Shell2023 in reply to MarkS]

thats great you can do aerobics while testing for afib. are you still being diagnosted or treated

[MarkS in reply to Shell2023]

Thanks. Yes I haven't had the results yet. I hope the EP won't suggest any drugs. I don't think they're required as my heart rate and BP are well controlled anyway 🤞

[JOY2THEWORLD49]

Hi

Your H/Rate with AF is better taken be stethoscope or physically.

The Micolife BP with memory and Pulse ends up with Err if your irregular pulse is too rapid for it. The Dr will do it this way.

I don't have any others. The clinic has a ECG.

I'm CONTROLLED in BP and Heart Beat.

I take CCB Diltiazem AM for control Heart Rate

I take BB Bisoprolol PM for control BP.

cheri JOY. 74. (NZ)

[FSsimmer]

I can feel your concern, but they are a waste of time for me. I have persistent Afib, so its not going to tell me anything I don't already know. As for heartrate, constant rate monitoring does nothing to help your anxiety, and anxiety is a big thing in Afib, it certainly does not help...I have had halter monitoring done which finds any issues and I am on medication. Even though I have a healthcare background ( I was a nursing tutor in the UL for over 20 yrs )...On a personal note I don't want one. but whatever helps will be good for you...All the best

[FSsimmer in reply to FSsimmer]

That should be UK !!!

[Shell2023 in reply to FSsimmer]

they can make you anxious. so even with medicine you are in persistent afib? what med do you take

[FSsimmer in reply to Shell2023]

Hi, Yep I am on Edoxaban 60mg once a day, Bisoprolol 7.5mg once a day Felicainide 50mg twice a day and Atorvastatin 20mg once a day...I must admit I have no issues with these or side effects...I have had an ablation, but this does not always revert the rhythm to Sinus, ( about 50% chance of success ). Lots of people are in permanent Afib, and its a question then of keeping your heart rate regulated....Fortunastely for me I have minimal symptoms

[Shell2023 in reply to FSsimmer]

wow thats a blessing you dont have alot of side effects

[Bunkular]

The reason why "unclassified" shows up are either there was movement during the reading or your skin and fingers were too dry. You can try it after slightly dampening (not wet though) the device at the 2 contact points and you should be good to go but keep as still as you can. Print out the report which indicates possible Afib so you can take it to your doctor.

[Shell2023 in reply to Bunkular]

ty i did try that do you sometimes think its the heart itself that is wrong but not registering or just always with testing errors

[PQuestor]

I have only ever gotten “Unclassified” results on mine. I have started to realize that what I really bought was a bookmark or paperweight.