Instagram for Heart Attacks: iPhone App Speeds ECG Transmission To Hospital Reply

In the crucial early stages of a possible heart attack, EMTs on the scene now rely on slow and unreliable proprietary technology to transmit vital ECG data to physicians at a hospital for evaluation. But a new iPhone app using standard cell phone networks may help speed the process and, ultimately,  cut delays in treatment for heart attack patients.

In a presentation earlier today at the American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions 2013 meeting in Baltimore, faculty and students at the University of Virginia designed an iPhone app to overcome some of the limitations of the current system. The iPhone app takes a photo of the ECG, reduces its size, and transmits the image over a standard cell phone network to a secure server. The image can then be viewed at the receiving hospital by physicians qualified to read an ECG.

Click here to read the full post on Forbes.

Opening Screen of the iPhone App
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What’s Next for the iPhone ECG Following Regulatory Clearance? 2

from Medical Device and Diagnostic Industry:

What’s Next for the iPhone ECG Following Regulatory Clearance?

 The user base and functionality of mobile ECG technology is set to expand.

“After recently winning FDA clearance and CE Mark certification, the iPhone ECG from AliveCor (San Francisco, CA), is poised to kickstart a disruption of the traditional ECG market.”

….

“In November 2011, Topol used the device to diagnose a myocardial infarction while on a plane en route from Virginia to San Diego. The plane made an emergency landing and the patient survived the ordeal.”

Click here for the entire article from Medical Device and Diagnostic Industry.

Unrecognized MI: More Prevalent And Dangerous Than Previously Suspected 2

Unrecognized myocardial infarction (UMI) is more prevalent, and is associated with a worse prognosis, than may be generally understood, according to a new study published in JAMA.

Studying an elderly (67-93 years of age) population in Iceland, Erik Schelbert and colleagues used ECG and cardiac magnetic resonance (CMR) to detect UMI. CMR was more effective than ECG at detecting UMI. The study established that UMI was twice as prevalent as recognized MI (RMI):

  • No MI: 74%
  • RMI: 10%
  • Unrecognized MI by ECG: 5%
  • Unrecognized MI by CMR: 17%

Diabetics were more likely to have UMI detected by CMR than by ECG. After 6.4 years of followup, mortality was higher in the RMI and UMI groups than in the group without MI:

  • RMI: 33% (CI 23% to 43%)
  • UMI: 28% (CI 21% to 35%)
  • No MI: 17%, (CI 15% to 20%)

After adjusting for other factors, UMI by CMR, but not UMI by ECG, significantly improved risk stratification for mortality. People with UMI by CMR were less likely than people with RMI to take cardiac drugs.

According to the authors, the large percentage of UMIs has not been understood in the past due to previous reliance on ECG data; thus “a significant public health burden” has not been fully appreciated.

Click here to read the JAMA press release…

USPSTF Maintains Recommendation Against ECG Screening Of Asymptomatic Low-Risk Adults Reply

The  US Preventive Services Task Force (USPSTF) has reaffirmed its 2004 recommendation against ECG screening for asymptomatic adults who are already at low risk for coronary heart disease (CHD). The Task Force also concluded that there was insufficient evidence to assess the risks and benefits of ECG screening in asymptomatic people at intermediate- or high-risk for CHD. The report has been published in Annals of Internal Medicine.

For asymptomatic people at low-risk, the report concludes that additional information obtained from resting of exercise ECG tests would be unlikely to change their risk assessment or to improve their health outcomes. By contrast, the tests are associated with “significant possible harms,” most importantly related to “exposure to potential adverse effects of invasive tests.”

The USPSTF weighed the evidence of the risks and benefits of ECG screening, but it did not include the cost of ECG screening as part of its analysis. The Task Force also recommends that physicians “individualize decision making to the specific patient or situation.”

The USPSTF notes that their recommendations differ slightly from current ACCF/AHA guidelines which state that resting ECGS are “reasonable for cardiovascular risk assessment in asymptomatic adults with hypertension or diabetes.” In addition, an exercise ECG “may be considered for cardiovascular risk assessment in intermediate-risk asymptomatic adults (including sedentary adults considering starting a vigorous exercise program), particularly when attention is paid to non-ECG markers such as exercise capacity.”