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October 09, 2018

Atrial Fibrillation: There’s an App for That

Atrial Fibrillation: There’s an App for That

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Mobile health technology has already had a huge impact on the medical world. Here, AliveCor provide the facts on atrial fibrillation and mobile ECG devices.

What is considered a normal heart rate?

A normal resting heart rate for adults ranges from 60 to 100 beats per minute.

Generally, a lower heart rate at rest implies more efficient heart function and better cardiovascular fitness. For example, a well-trained athlete might have a normal resting heart rate of around 40 to 50 beats per minute.

What is atrial fibrillation?`

Atrial fibrillation (AF) is a common abnormal heart rhythm that happens when electrical impulses fire off from different places in the atria (the top chambers of the heart) in a disorganised way. This causes the atria to twitch, and can be felt as an irregular heartbeat or pulse. Atrial fibrillation is a major cause of stroke.

What causes atrial fibrillation?

The exact cause of atrial fibrillation is unknown, but it's more common with age and affects certain groups of people more than others. People aged 65 years and above are particularly at risk of AF.

An episode of atrial fibrillation can be triggered by several things—including high blood pressure, heart valve disease, and excess alcohol consumption, particularly, binge drinking. Smoking; being overweight; excess caffeine consumption from tea, coffee or energy drinks; or taking illegal drugs, such as amphetamines or cocaine, can all contribute to AF. It’s also associated with coronary heart disease.

In many patients, no underlying cause can be found. Sometimes AF can be resolved if the underlying triggers can be removed.

What are the symptoms and dangers of atrial fibrillation?

Some people with atrial fibrillation, particularly older people, do not have any symptoms, and diagnosis is often only achieved when investigating other conditions.

The most obvious symptom of atrial fibrillation is heart palpitations—where the heart feels like it's pounding, fluttering or beating irregularly, often for a few seconds or, possibly, a few minutes. It can also be continuous.

As well as an irregular heartbeat, your heart may also beat very fast (often higher than 100 beats per minute). Other symptoms you may experience include:

  • Tiredness and being less able to exercise
  • Breathlessness
  • Feeling faint or lightheaded
  • Chest pain

The way that the heart beats in atrial fibrillation reduces its performance and efficiency. Blood does not flow normally through the heart, which can lead to clot formation.

Consequently, patients with AF are five times more likely to experience a stroke. As the clots formed can be quite large, the resulting stroke can cause significant damage to the brain, from which patients may not recover.

How can someone with atrial fibrillation build a stronger cardiovascular system?

Patients can take several steps to improve their heart health. Losing weight where necessary, a low fat/low salt diet, giving up smoking, and drinking less alcohol and caffeine will all help to improve the situation. Ensuring your blood pressure is under control is also very important. Additionally, regular exercise will contribute to a stronger cardiovascular system.

What is an ECG and whom does it benefit?

An electrocardiogram—or ECG—is a simple and useful test, which records the rhythm and electrical activity of your heart. Small, sticky patches called electrodes are put on your arms, legs and chest. These are connected by wires to an ECG recording machine, which picks up the electrical signals that make your heart beat. This electrical activity is recorded and printed onto paper. Each peak (identified by a particular letter) represents a single action of the heart, which altogether makes one heartbeat.

An ECG is often used alongside other tests to help diagnose and monitor conditions affecting the heart.

It can be used to investigate symptoms of a possible heart problem, such as chest pain, palpitations, dizziness and shortness of breath.

An ECG can help detect:

Arrhythmias—where the heart beats too slowly, too quickly, or irregularly

Coronary heart disease—where the heart's blood supply is blocked or interrupted by a build-up of fatty substances

Heart attacks—where the supply of blood to the heart is suddenly blocked

Cardiomyopathy—where the heart walls become thickened or enlarged

How does an ECG mobile application work?

These devices, as the name implies, are usually small and light and can therefore be carried easily by the patient. They often have some hardware combined with an app on a smartphone or tablet. The hardware works in the same way as a hospital ECG machine, by collecting the heart’s electrical activity. It’s then converted to the waveform by the app and displayed on the phone’s/tablet’s screen. With KardiaMobile, the patient rests their fingers on the two electrodes for thirty seconds and the recording is complete. The app then analyses the result and can accurately identify atrial fibrillation. Importantly, the result can be instantly emailed to the doctor helping to reduce time to diagnosis and the start of therapy.

What are the advantages of ECG mobile applications?

There are several advantages to this type of device. As mentioned above, they can dramatically reduce time to diagnosis and therapy. They are usually easy to use, highly portable, and patients can become more engaged in their healthcare management. A further effect can be giving patients peace of mind by being able to record a cardiac event as it happens. Doctors can often find it challenging to capture these events by traditional methods, and therapy cannot commence until they have hard evidence of a condition.

Are these devices as effective as other heart monitor techniques?

Each device used by clinicians has its own advantages and disadvantages, and the selection is normally dependent on the need.

There is a wide range of mobile devices available on the market now, and some have been tested and used more than others. All should, however, be classified as Class IIa medical devices to demonstrate accuracy and efficacy. Some are approved by the FDA in the USA, lending extra weight to their validity. Published scientific research papers also reinforce the product’s reliability.

Once these factors have been established, there should be no reason to doubt the efficacy of a device for its prescribed use.

How is mobile health technology impacting the medical world?

There’s no doubt that mobile health technology has already changed the medical world over the past few years. The UK’s National Health Service has realised the potential and thus introduced a body called the Academic Health Science Network. Their sole task is to search for new technologies and software products that could not only improve outcomes for patients, but also offer savings over current methods.

Patients are becoming more involved in their healthcare and, in many cases; they are taking their own steps to improve their health by using these new types of technology. For example, there are apps available today that interact with a patient to help them make an assessment of their condition and recommend (or otherwise), a visit to the doctor. Others provide valuable advice and monitoring of an already diagnosed condition.

These, on the surface, simple apps can help to reduce interaction with the health service. Visits to the emergency department and a reduction in consultant and GP appointments all help to maximise the resources of the NHS.

Doctors have been interacting with mobile apps for some years and they are now able to seek advice on anything from clinical decision making, to drug prescribing, to disease states and NICE recommendations.

There is no doubt that we are only at the beginning of the revolution. And, as technology continues to develop exponentially, we can only imagine how the situation may look in just five years time, let alone ten.

KardiaMobile from AliveCor was one of the AHSN’s first products to be successfully taken through their assessment process, and it’s now being adopted across the service. For more information, visit alivecor.com