Wellue ECG - review

[Cliff_G]

Does anyone else have a Wellue ECG heart monitor (single lead Holter)? Any conclusions?

I happened to find them advertised for £150 a couple of months back and took the plunge, as I have a lot of ectopics etc etc.

My thoughts:

Pros:

- Allows you to trap events at your own convenience, a good alternative to seeing a doctor to get a Holter, by which time the issues may have disappeared.

- Small, light, easy to fit and wear. Use ECG pads or a chest strap.

- The single rhythm strip trace looks to be worthwhile especially to a skilled ECG reader

- Up to 24 hour traces

- Can send a pdf of a report on a session, and a pdf of the entire trace for analysis by others.

- AI analysis of the traces

- Report format is good and manageable (about 10 pages) with count of event types and samples of each event type

- can use for multiple persons, in that the computer storage can be allocated to named individuals

Cons:

- as far as I can tell, it's not medically approved (e.g. FDA)

- really need someone able to review the ECGs [edit 16/3: i.e. a professional - but true of any such device]

- 24 hours of trace is a huge pdf file (500 or so pages), not easy for a doctor to handle [Edit 16/3: but you can select individual pages by time or from your own manually logged events]

- can't easily install the software on another computer (particularly a doctor's one in a - hospital/surgery) to read the traces (software security issues too)

- single lead means multi-lead analysis can't be done, such as when looking for atrial flutter in different leads

- the baseline drifts if you are moving/active - best to sit or lie still at least long enough to see the proper waveform for an event you feel

- the AI analysis is to my mind not terribly good. If you have a regular rhythm with occasional events, it's probably ok, however, with a lot of events it throws up a large number of event analyses which may not be terribly acccurate, and can miss things like short AF or AFL bursts in amongst the mass of data. I also have a virtually non-existent p-wave due to my ablation years ago, and I think that throws its analysis off too.

- an occasional problem with locking up USB ports/freezing on your computer. Best to start the program, download the trace, then disconnect the device straight away.

Overall

- great to be able to have it to hand to trap events without the rigmarole of going via a doctor, by which time the First Law of Holters kicks in - nothing to be seen!

- if you can select sample pages from the overall ECG rhythm strip trace to show a doctor, then it may be helpful to them. I have a cardiologist appt in a few weeks to review a proper holter done by them, and will take a few pages which I think may be of interest

- if you can learn to read ECGs it would really help... [edit 16/3: ... you to be able to select pages to show your doctor]

- the offer price I found seems to have disappeared

A more detailed review is at theskepticalcardiologist.co...

For clarity: my post is a consumer review, and I have no connection to the company.

[Espeegee]

Did you choose that over a Kardia? I've not heard of it, it sounds quite cumbersome although the 24 hour reading is a potential advantage over the Kardia but 500 pages is an awful lot of data

[Cliff_G in reply to Espeegee]

My criterion was to have something I could wear which would trap things passively, also to count the instances of events. For the rhythm disturbances I'm getting, the Kardia (as I understand it to be something you have to go find, then hold the pads) wouldn't really do the trick, nor could it tell me what was happening overnight.The 500 pages is not really a function of the device, just the recording time, at 25 mm of trace/sec. My cardiologist has in the past said that for example a 7-day monitor can produce just "too much information". I find it fairly easy, though, to scroll through and print a few what look to me to be typical pages.

[Espeegee in reply to Cliff_G]

Ah I see. The Kardia is portable but I think the max reading is 60 seconds and you have to hold it in place.

[baba in reply to Espeegee]

You can record up to five minutes on Kardia.

[Espeegee in reply to baba]

Gosh, didn't know that, thank you.

[baba in reply to Espeegee]

Yes, but you do have to sit still and the automated analysis only looks at the first 30 seconds.

Whatever else happens during the 5 minutes is recorded and can be viewed, printed or shown to medical team.

Mine is set for 5 mins but I can stop recording anytime after 30 seconds.

[mjames1]

Excellent review, thank! And for anyone interested, please also read Dr. Anthony Pearson's review a well, which is linked at the bottom.

Never tried the Wellue, but from what I've read it' an excellent device for a small minority of afibbers who want 24/7 monitoring, are technically minded and are able to read and interpret ekg's to at least a moderate extent -- or at least have an ep willing to wade through a very large file for a more definitive interpretation.

For the rest, best stick to the more consumer friendly Kardia and Apple Watch which are medically certified. And where 24/7 monitoring is required, then see your doctor for a Holter.

Jim

[bean_counter27 in reply to mjames1]

I have one but only just starting to use it after an initial test when I got it 3 months ago.

Some thoughts:

Can't really do 24/7 monitoring. Device needs to be removed to download data and to be recharged. Also can't wear while swimming, showering etc.

I don't know how good the AI analysis feature is but I will be taking a few summary reports to my annual review with cardiologist for his review and thoughts. My first use included recording my most recent AF episode.

It produces a summary report so don't necessarily need to wade through pages of ECG's to find anomalies. It also has a table with hourly statistics - HR - average, min, max, Ventricular - PVC, Couplets, Runs, Bigeminy, Trigeminy, Atrial PVAC, Couplets, Runs, Bigeminy, Trigeminy, Bradycardia.

The hourly statistics would assist in narrowing down the section of ECG to review. In addition, as Cliff_G indicated, the summary report also includes sample of ECG where a type of each anomaly occurs. These samples have date and time shown, enabling a reviewer to go directly to the area of the full ECG recording that the anomaly is from so they can look at before, during, after supposed anomaly.

I have Kardia 6L and Withings Scanwatch. I got the Wellue to do occasional recordings while I sleep - an area where episodes might otherwise go undetected. I will probably put it on when I am having an AF episode so that I can record what happens and accurately determine when it has ended.

Last night I put it on after a few isolated flutters. I checked and was confident it was not AF but thought I'd do a recording and identify what the flutters were. It reported 2 PAC's in the first 17 minutes. In the 9hrs 46min recording it reported I had 11 PAC's (including 1 couplet) and 2 PVC's. Was it right? Don't know - but will see what my cardiologist thinks of it.

[mjames1 in reply to bean_counter27]

Thanks for the comments. I find my Apple Watch enough to monitor any night time afib episodes, since it monitors both afib and high heart rates while I sleep. I think the Wellue, like all these devices has its plusses and minuses, well laid out in the OP's review and the linked professional review in Dr. Anthony Pearson's column.

Jim

[bean_counter27 in reply to mjames1]

Jim

Whether intended or otherwise, your response is somewhat dismissive.

You are clearly quite intelligent and knowledgeable when it comes to AF. As a consequence, I normally respect you comments.

However, in this case the OP's post started with

"Does anyone else have a Wellue ECG heart monitor (single lead Holter)? Any conclusions?"

You obviously don't have one and as you stated, you've never even tried the Wellue. However you offered your opinions anyway. Why?

Given you don't have a Wellue, how do you know whether the OP's review or the linked professional review cover all of the "pluses and minuses"?

I responded to you posts because some of your comments are more misleading than informative. Not having used a Wellue you are reliant on what you can glean from the reviews/comments by others.

"Chinese whispers" then starts to apply! e.g.

- you refer to it as a 24/7 device, when the linked review makes it obvious that it's not;

- users need to be "technically minded and are able to read and interpret ekg's to at least a moderate extent" - it has AI analysis.

- EP would need to "wade through a very large file" - absolute worst case scenario, which is highly unlikely given summary report:

+ provides sample trace of each anomaly type detected i.e. EP can decide whether it is AF or not;

+ sample trace has date/time stamp so easy to go straight to that section of PDF to find the sample and EP can selectively look at lead up and subsequent trace if further review required

+ hourly statistics table in summary report assists to narrow down scope e.g. last AF episode shows 0 PACs most hourly blocks but 108 in 1 hour block at 11am, then 93, 42, 6. So, EP could head straight to 12 noon and look at trace around that time.

The above knowledge of the summary report's usefulness was acquired from using the Wellue. It wasn't in either review.

[mjames1 in reply to bean_counter27]

Beancounter: You obviously don't have one and as you stated, you've never even tried the Wellue. However you offered your opinions anyway. Why?

It's similar to how here many of us discuss treatment options they we personally haven't undergone. We rely on research, information from healthcare professionals, and experiences shared by others to offer insights. Not to say it's the same as having first hand experience, but I was quite clear I didn't.

As to my response to you being "somewhat dismissive". While that was certainly not my intention, I actually had the same thought as soon as it was posted. I therefore was about to revise the post when something else came up and then I forgot. So apologies on that and hopefully no hard feelings.

Jim

[Ppiman in reply to mjames1]

Jim

Now, now. You complained that I was "promoting" the Wellue recently, then seemed to agree that I wasn't (and I surely am not). But your post is far too reductive of it, and, I would say, too effusive about the Kardia. If you are going to make such detailed comments about a device of which you have no direct experience, well - then I am surprised.

The Kardia is a lovely device to use and look at, and, like the Apple Watch, has FDA and NICE approval, so far as I know (but whatever that actually means, I do not know). Wellue gives a few advantages over the Kardia which can be important:

1. The possibility of using ECG electrodes produces a noise free ECG trace (anyone who has looked at the pre-smoothed Kardia trace will know just how much noise their algorithm removes).

2. The possibility of taking an ECG from 5 minutes up to 24-hours. This is unique for many people since the easy availability of a Holter ECG monitor, or the expense of a ZIO monitor, is not an option for all outside of those lucky to afford private medicine.

3. The smaller Wellue device is very similar to the Kardia but allows wrist or chest electrodes for noise-free traces.

4. The AI report seems to me to be entirely useful and is something to take along to a doctor if more advice is needed.

5. There is absolutely no requirement to be able to "read an ECG". Wherever did that idea arise?

Steve

[mjames1 in reply to Ppiman]

Steve: The Kardia is a lovely device to use and look at, and, like the Apple Watch, has FDA and NICE approval, so far as I know (but whatever that actually means, I do not know).

FDA approval means a medically recognized and respected third party has thoroughly evaluated the device and all claims, including specificity and sensitivity (false positives and false negatives).

Steve: The AI report seems to me to be entirely useful and is something to take along to a doctor if more advice is needed.

Well both the OP and myself disagree. Maybe you have some sort of bespoke medical service, but I'm lucky if my ep will sit down and look at more than three thirty second Kardia ekg's, before they run out of time. 500 pages???? Not likely

OP: 24 hours of trace is a huge pdf file (500 or so pages), not easy for a doctor to handle

Steve: There is absolutely no requirement to be able to "read an ECG". Wherever did that idea arise?

Please see bullet points "2" and "7" in OP's review under "Con's". Also see the professional review the OP linked in Dr. Anthony Pearson's Column, where they made a point that fortunately the reviewer was trained to read ekg's because the AI analysis was so often wrong.

Jim

[Ppiman in reply to mjames1]

The reference that the OP made of needing to be able to read an ECG implied that was aimed at the lay user of the device, not a cardiologist, hence my comment. The Wellue scan is, of course, large if it runs for hours, but it summarises all the main findings separately and gives an example of each finding taken from the ECG. It really is a well-presented summary.

Regarding FDA approval, I wouldn't want to gainsay you there except to say that the Wellue device is made by Viatom, which appears to be a bona fide R&D based medical equipment manufacturer and one that has specialised in ECG equipment for many years. The Wellue products are a part of their consumer range, but the AI analysis appears to be the same as they use professionally.

The quality of the ECG scan seems extraordinarily good to me. Of course, in certain contexts, it will be less good, such as activity, showering and similar. There is no smoothing of the trace needed as electrodes provide a clean signal, unlike any other home device.

For home use, it seems ideal and for the ability of it to prepare a small document to take to discuss during a visit to a doctor, well, I cannot fault it.

Steve

[mjames1 in reply to Ppiman]

Like I said, I'm not for or against Wellue. I just think it's a niche product that does not have the broad appeal/benefit of a Kardia or Apple Watch, along with the other caveats I've mentioned per reviews, etc.

As I mentioned previously, I may end up getting one to track my tachycardia episodes, which I still don't have a definitive diagnosis on. While I capture them on the Kardia, during the episodes (5 - 30 minutes), I think I could get more diagnostic information for my ep with a wearable like Wellue, that would show how my heart transitions from NSR to the tachycardia and then back to NSR.

So, given my episodes are about every 10 days, I guess the strategy would be to wear the patch continuously until the event happens. Then download the event with the NSR bookends and email to the ep.

So given that strategy, how many disposable patches would I need to get? My understanding is that the patches will generate a cleaner ekg than the belt, which is what I want.

Jim

[Ppiman in reply to mjames1]

For sure the patches are better, and some are better than others as some stick too firmly and are (ouch!) to get off.

My personal thoughts about the two Wellue devices are, I can sense now in myself, skewed because I also have a LBBB and a wide QRS and Kardia seems aimed firmly at AF sufferers, i.e. those who have a "clean" atrial arrhythmia. The act is that the Wellue AI picks up so much more. I saw my GP today with the scan I took during my last episode and he wasn't happy about some of what it showed, so I am off to see my cardiologist EP a week on Tuesday (with my fingers crossed and hoping the AI isn't as wonderful as I have been thinking!) - but still very grateful for the Wellue.

Steve

[mjames1 in reply to Ppiman]

Thanks.

1) So what are the best patches for the most accurate monitoring, where do I get them and how much do they cost?

2) How many of these patches will I need for ten days of continuous monitoring?

3) You said...My personal thoughts about the two Wellue devices. I wasn't aware there were two Wellue continuous monitors. Which one is the best for ten days of continous monitoring?

Jim

[Ppiman in reply to mjames1]

I could have been clearer. Sorry, Jim. There is only one for Wellue AI for up to 24 hours recording (apart from their 12-led semi-pro models). The other that I have records up to 5 minutes, like the Kardia, but with the option to use chest or wrist electrodes.

The patches I use are from Amazon and have a gel area: Skintact ECG Electrodes (Pk 30, made in Austria). I am sure locally made ones would be as good. I would check the Amazon reviews for comments regarding ease of removing. It's a balance as they also need to stay on. I have only used mine while sitting or sleeping and, so far, they have been fine. The Wellue device clips onto the pads using a press-stud fastening.

Steve

[Cliff_G in reply to mjames1]

Jim,

1. Wellue sell replacement patches in 60's (so, 30 pairs), works out about £1.15 a pair including shipping (which is half the price of their electrodes). I've seen elsewhere that 3M Red Dot patches are equivalent, a little more pricy per item but then no shipping and about the same total shipped price from a well-known online retailer

2. You'd need approximately 10 pairs, but you won't get truly continuous monitoring as the device needs to charge between sessions, each session is a maximum of about 30 hours. I think the charge time is about 5 hours on my USB hub connected rig. At least doing that you can have a shower betweentimes, that's one aspect I hate with a hospital Holter, not being able to shower.

3. My cardiologist's advice a while back was that much more than 24 to 48 hours provides "too much information" and though I insisted on a 7-day at that point, nothing came out of that particular session that wouldn't have with 48 hours. Obviously, if you're not trapping events within that 24-48 hours you'd need to go on for longer, but my experience of cardiologists is that if you're not able to trap events in a 48 hour session then they are insufficiently frequent to be of concern. I don't always agree with that, but I can see the argument.

HTH

[mjames1 in reply to Cliff_G]

Hey, thanks a lot! My episodes run only during the day, so I'd probably wear the Patch from 10 am to 6pm until I captured an episode. Then discard patch and put a new one on the next day That single episode is really all I need to show the ep. As mentioned, they are running about one episode every 7-10 days.

Jim

[mjames1 in reply to Cliff_G]

Cliff: Obviously, if you're not trapping events within that 24-48 hours you'd need to go on for longer, but my experience of cardiologists is that if you're not able to trap events in a 48 hour session then they are insufficiently frequent to be of concern. I don't always agree with that, but I can see the argument.

His opinion seems to go against the whole concept of extended Holter monitoring. At least in the US, the standard is a 7 day Patch, which then can be extended another week or two if needed.

Even though my events are only once every 10 day, the concern is both that the 5-30 minute episodes take a lot out of me and also that they can sometimes trigger afib. So capturing not only the event, but the before and after, will help identify it better which may lead to a treatment strategy at some point.

I could alternatively ask for a 7-14 day Patch, but the Wellue might be more convenient in a number of respects. My only hesitation is that it might offer too much data that I don't want. It's unclear how important short, sub-clinical afib and other arrythmia's, but once it's put in my head that I'm having twenty 1-2 second afib episodes a week, it will be hard to get out of my head !!!

But that same problem could come from the Holter. Maybe this dynamic is in part what your doctor is talking about and in if so, I agree.

Jim

[Cliff_G in reply to mjames1]

Yes, it may be a difference of approach between the US and the UK. I've normally only had 24 hr tapes on the NHS, but one 48 hour one. This was in early Feb just recently and thankfully caught a bad bout of exactly what was happening during the second 24 hrs and led to an instant appointment letter (I await the appt with interest!). The 7 day one I had was a request from me on a private consultation a couple of years ago and proved a waste of money!

At rhe appt I'll also have some selected pages from my Wellue data to show some before and after behaviour.

[NewOne2023]

I don't own holter but a portable ecg monitor (2 points) from Wellue. It's really practical and it seems accurate. You can take a 30sec or 5min recording with additional AI analysis and you can export recordings as pdf for your doctor to see. The thing is I bought it in January but luckily I didn't have an af episode since December so I can't really tell how good it captures af. It did capture a pac once. And I think it's much cheaper than kardia. Around 70 dollars or so.

[Cliff_G in reply to NewOne2023]

Is this the one with an app for your phone?

[NewOne2023 in reply to Cliff_G]

Yes

[fairgo45]

PI'm a Kardia user have been since it came out and for capturing an instant reading of afib its the best device for the price.I also have the wellue 24 hour holter monitor and I bought it because of my afib becoming permanent for the last year.

My previously good fitbit versa 3 could not pick up a lot of the data anymore and my heart rate was in the 40s a lot I also developed heart failure so I wanted to know what happened while I slept.

I didn't have the setup problems or freezing issues I find it easy to use and the results easy to convert to pdf to show my cardiologist of course not all of them because there are hundreds but the ones that are highlighted by the program I do it with those that show something interesting like SVT or bradycardia.

I'm not saying it's as accurate as a holter from your cardiologist but it's an interesting device and not expensive so I'd recommend the wellue for home use.

If anyone has a watch that workes with permanent afib results please share the make with me

[fra48]

hi, I bought one last August l. u can print single pages out of the 500 by simply printing them on pdf. And i realized that is helping to deactivate the Bluetooth on the phone while downloading data via the usb otherwise it sometimes get blocked; since i deactivated it then i had no more blocks. I brought some of them with me to my last EP visit and he judged the track as very good. And better to use with electrodes and a bit of gel than with strap. AI analysis is not perfect but very helpful in identifying which of the 500 pages is worth to be checked. And yes track is not so stable when u move or execise but i use it when sleeping because anyhow during the day i am able to detect on my own if I have an issue and in that case u can wearnit quickly with the strap. Overall i am satisfied with it. I also have an apple watch which is an additional monitoring for the nights i don’t wear the wellue.

[MikeThePike]

I bought one a few months ago but have not actually used it. It looks like a brilliant device and I hope to use it sometime when I get a chance. I think you just need to make a note of the time you experience any symptoms and mark that timepoint on the graph. Simple really. Your doctor or EP can do the rest.

[Ppiman]

I changed from Kardia to two Wellue devices, the 24-hour version and the smaller one. I have written a few reports on these here. I find them both excellent and haven't been able to fault them, in fact. The AI report and the quality of the ECG trace is simply astonishing.

If you search for my posts you'll find my reports. I bought them on recommendation of two others here who have also reported on their experience, all positive. Alternatively, please send me a message, and I can answer any questions you have.

Below is the report (not the trace) from the last time I used it. Sadly, I notice the image becomes distorted because of this site's web rendering.

Steve

Wellue ECG AI report

[Ppiman]

Hi Bob. That’s good to know as on my MacBook looking at it just after I posted the first, the image was rendered so stretched as to be all-but illegible. I made the second one a smaller section of the first that I hoped would reproduce better.

I have edited my posts now thanks to your post.

Steve

[Cliff_G]

Thanks for the comments, folks. My response on a few of these: No, not 24/7 but certainly 24 hrs-plus (I think 30 hrs is the limit.)

I'm not aware of any ECG device which can be used swimming or showering; water and mV-level traces don't mix, never mind the device itself.

The point about logging events manually and printing just those times is a very good one, after all, it's what they suggest when you get a hospital Holter.

Re. the AI analyses and the Summary Report with examples, I think the skepticalcardiologist review hit the nail on the head here. If the trace is largely NSR with a limited number of anomalies, it's probably very good. However, I have found the AI analysis considerably lacking when I'm not largely in NSR. Firstly, I have an almost absent p-wave which seemed to disappear when I had my ablation in 2002. Maybe a 12-lead will find it, but it's rare that I can see it on a single-lead monitor. No p-wave probably leaves AI floundering. It picks up my PVCs ok, bigeminy and trigeminy ok-ish (I get hundreds of these), but is very poor at flutter and not great at AF either. The "percentage in AF/AFL" value doesn't seem at all reliable to me. Single lead is not the best lead placement for flutter, but a mild saw-tooth baseline indicating AFL should trigger the AI, and whilst it does do this occasionally, I can spot other episodes it misses. I think my lack of p-wave may mess up its view of AF.

The point about being helpful if you are able to read an ECG, at least at a basic level, is not a necessary thing at all. Yes, just print the times you log feeling an event and/or the summary pages, but with a busy trace like mine and the AI analysis missing things, you will be able to better select what you give the cardiologist.

[Cliff_G in reply to Cliff_G]

Oh, and, proper hospital 12-lead ECG analyses are also far from perfect, and it's best a cardiologist looks at them too, so perhaps we shouldn't expect too much from the Wellue.

Having said that, there's a paper a couple of years ago on the use of AI to analyse ECGs, and one finding was that AI can even detect early onset of heart problems - what initially were thought to be false positives turned out years later to have been early signs which developed fully later. Now that's impressive! See Pubmed PMID: 34534279 and search "previvor"

[bean_counter27 in reply to Cliff_G]

My comment about not being able to wear when showering or swimming was part of my explanation why it is not a 24/7 device i.e. not that it was incapable....

[Banquo]

I've been happy with mine. I get a lot of my ectopics when laying down/overnight, so the Wellue has been nice to have, albeit any tossing and turning etc affects the reading when wearing the chest strap, which is mainly how I use it. I've even used the app more and taken a few minutes in recording if I feel a bout of palpations, etc. I did hesitate to buy knowing it wasn't FDA approved, but am glad I finally did. I recently had a 14 day Holter and it jived very closely with the Wellue as far as I could tell extrapolating the totals and general pattern of findings. My EP was impressed and hadn't heard of the Wellue. He is a gizmo advocate himself and obviously promotes the known favs to his patients, like Apple and Samsung and Fitbit watches and the Kardia. I have had a 6l Kardia for the last several years as well and it's a great device, albeit I can have a bugger of a time getting a reading sometimes without it finding interference, etc. Garmin finally now has a few watches with the ECG feature as well. But I'm finding I use the Wellue strap the most simply because of the passive ability and use overnight. Honestly, sometimes it can get tired of seeing all the ectopics I still have and miss the relative clean readings of yesteryear, but if you like knowing and enjoy or at least tolerate gizmos, it's a decent option. I imagine using the sticky pads would be even more accurate and fewer interruptions..but I've never used those.

[OzRob]

I reviewed the 24 hour AI Wellue monitor on this forum some time ago. My EP told me the data produced was the best he had seen from a consumer product.

Medication has halted my AF for the last 14 months, so I no longer hook up the Wellue monitor, however, I always use it the night before my six monthly EP appointment to show my EP.

[Cliff_G]

Some minor edits (annotated) to the original post to clarify things discussed in the thread which I was not particularly clear on.