Kardia ecg

I know some folk use Kardia with their Pacemaker. Can anyone tell me if it records ectopic PVC's on the device. I'm blighted by them especially at night!! Just wondered if it is worth getting one as kardia do say it should not be used with a PM!


10 Comments

Kardia Mobile

by Gemita - 2020-05-27 06:01:38

Hello Wazza,

I do not have a Kardia Mobile but I have been considering buying one.  It is true that Kardia Mobile does not recommend the use of its product with a pacemaker mainly I believe because it has not been fully tested for use with a pacemaker and that a pacemaker is likely to cause some interference and possible inaccuracies at least for the untrained eye.  But for a specialist in reading ECGs, I cannot see that there would be a problem.

My feeling is that it is still one of the best home monitors out there (recommended by my doctors - especially the new 6 lead one) where we can record a decent ECG when we are "actually having symptoms" and then we can send this information or take this information to our doctors for a full analysis.  Having a pacemaker makes even a hospital grade ECG difficult for many doctors to accurately read, but not for an experienced doctor.  Indeed, my last hospital ECG report stated "frequent PVCs" which my cardiologist quickly corrected to "atrial ectopic beats with aberrant conduction (right bundle branch block)" so machines often get it wrong (!)

Unless we know how to read an ECG, the Kardia mobile may not give us a clear diagnosis each and every time, for example a run of Premature Atrial Contractions (PACs) may sometimes be wrongly interpreted by Kardia as runs of Atrial Fibrillation but it will certainly record what it actually sees, including symptomatic Premature Ventricular Contractions (PVCs) which can then be kept for a full analysis by your doctors.

If I am not mistaken, I have read on this site that if our pacemaker "electrogram recording" is turned on, our device will automatically record an abnormal rhythm, especially a serious one, although I doubt benign ectopics (PACs/PVCs)  would be "automatically" included.  I believe our doctors can record the number of ectopics we are getting over a period and when this percentage is sufficiently high enough, they might recommend treatment. 

My feeling though is that with a home monitor such as Kardia Mobile you can be in "control" of when and where you make a recording and what heart rhythm disturbances (according to your symptoms present) will be of particular interest to you, so if you can afford Kardia Mobile, I would go for it

 

Kardia ecg

by WazzA - 2020-05-27 08:23:08

Thanks I know my PM has picked up pvc's within the parameters set by my EP but is certainly  missing a lot of the shorter ones!!! We know they aren't all life threatening but boy they are annoying! I may well invest in one soon.

No, well...

by AgentX86 - 2020-05-27 08:46:50

The Kardia Mobile won't diagnose PVCs. The will ONLY detect "Afib", "Potential Afib", or "no Afib". However, you can learn how to read EKGs so that you can see them. That said, at least from my experience, they announced themselves well enough. I thought Flutter was bad enough.

PVCs

by Gemita - 2020-05-27 08:59:02

Yes WazzA they are a real pest as are PACs and always spell trouble for me. I usually don't get over difficult symptomatic runs of PVCs or PACs without them deteriorating into more troublesome arrhythmias like Atrial Fibrillation, Flutter, Atrial Tachycardia/SVT and even Ventricular Tachycardia.  Stop the ectopics I say and you will stop the others (!).

Pacemaker missing PVCs

by AgentX86 - 2020-05-27 09:02:45

PVCs are so common,  even in the "healthy" population that pacemakers don't/can't record rhem all. They have a programed minimum PVC run length, so unless there are a series of PVCs longer than that setting, they won't be recorded by the PM. My PM has a minimum run length of five. It can't be set lower. My bigeminal PVCs flew right under the RADAR. I could certainly feel it. One evening they showed up when I was close to my remote monitor so sent a strip. That's a full EKG so it was trivial for even the PM tech to diagnose them.

Kardia and Pacemakers

by Selwyn - 2020-05-27 11:26:16

The Kardia is quite safe with pacemakers. It is just that the literature supplied does not cover their usage as the original work was not done on pacemaker patients.

I have used a Kardia for years.  It is useful to travel with ( fits in my wallet). It offers some reassurance ( or otherwise) that the rate and rhythm of your heart is OK. It should not be used for diagnosis.

Kardia with pick up extrasystoles ( ectopic beats)  including PVCs.   What you get on the basic Kardia is a one line EKG( ECG). The software will detect these. The odd one is neither here nor there, however if you are having a lot of ectopics the software thinks you may have atrial fibrillation as it seems to be sensitive to the regularlity of the QRS complex on the ECG ( ventricular contractions), rather than P waves ( atrial contaction). So, Kardia is good at telling you the regularity of your heart. It may think you have atrial fibrillation when you haven't. It also reports that the ECG cannot be interpreted ( There is an paid for option to let someone remotely look at your ECG). You can print of your recording as a .pdf and send this onto your physician. Although I do not get PACs, andso have not seen a Karida print out of these, in theory you should be able to see P waves that come with these.  A basic knowledge of ECG ( see https://ecg.utah.edu/lesson/1 ) is helpful if you want to self diagnose. Especially if you only have one problem, it would be easy to get a little instruction as to what to look out for on the Kardia.

After my first atrial fibrillation ablation I was still getting a bouncy irregular pulse. I recorded my ECG via Kardia, ( no P waves and irregular QRSs)  took the .pdf on paper to my cardiologist, and in this way I was believed that the procedure had not been effective, in spite of being in sinus rhythm on the hospital 12 lead ECG.

The latest Kardia ( and  bit more expensive) is a 6 lead display machine. There seems to be little point in this as most arrhythmias are easy to detect on the single lead machine. I am not sure why you would need 6 leads - if you were having symptoms of a  myocardial infarction you should just be phoning for an ambulance rather than taking your ECG ( which may be normal in the early stages of this potentially lethal condition). A single lead ECG is fine for detecting your usual problem(s).

One Lead vs. six lead

by AgentX86 - 2020-05-27 11:45:53

Atrial flutter doesn't show on lead-1 of an EKG, so single-lead EKG can't show that the SVT is caused by flutter or something else.  With six-leads, it can be seen (asynchronous sawtooth waveform on lead 3, IIRC).  There is a way, on a single-lead EKG to see some of the other leads, by puting one of the electrodes on your hand an one on another part of the body (knees?) but these hacks can't be time correlated.

I don't need one anymore, so gave my single-lead to my son.  If I thought I'd see something useful, I'd certainly spend the extra $50 for the six-lead model.

Kardia and atrial flutter

by Selwyn - 2020-05-28 12:25:30

You don't have to be a genius to realise that your Kardia ECG is showing a fast heart rate, typical of atrial flutter, in Kardia lead 1 when you are experiencing a fast episode of palpitations. Not only will lead 1 ( ie. Kardia) show the rate, but also it will show loss of P waves.(should you have any experience of reading ECGs).

At no point should you use Kardia for diagnosis. It is there to show that your heart's ECG is not normal .... that is all. Kardia is licensed to show atrial fibrillation  ( irregularity of QRS and lack of P waves). Kardia will also report a tachycardia (>100 bpm, as in atrial flutter)

Whilst atrial flutter is best seen in lead 2 of a 12 lead  ECG ( as a saw tooth of multiple P waves), lead 1, which offers a more lateral view of the heart also shows changes ( see http ref.below).  I have personally taken my Kardia print outs to my cardiologist showing flutter changes... ended up having a flutter ablation. Unless you are in the realms of trying to self diagnose with a six lead ECG ( which is something I would not advise, as who in their right mind would try and diagnose with half a picture), the single lead Kardia is OK for basic screening though not for diagnosis.  You need to have a professional quality 12 lead ECG for diagnosis.] You should never rely on a 6 lead ECG for diagnosis.

See https://www.researchgate.net/profile/Cristian_Statescu/publication/318357744/figure/fig6/AS:515116887621632@1499824844847/Standard-12-lead-ECG-atrial-flutter.png

for the ECG changes of flutter in a 12 lead ECG.

The following is directly printed from the Kardia 6 manual:

DO use this device to record heart rate and heart rhythm only.
2. DO NOT use to diagnose heart- related conditions.
3. DO NOT use to self-diagnose heart related conditions. Consult with your physician before
making any medical decision, including altering your use of any drug or treatment. Interpretations made by this device are potential findings, not a complete diagnosis of cardiac conditions. All interpretations should be reviewed by a medical professional for clinical decision-making.

Complete nonsense.

by AgentX86 - 2020-05-28 12:55:14

My atrial flutter was between 80 and 90bpm, not fast at all.  It started out as a higher rate than normal but would break into an irregularly irregular heartbeat, like Afib, not a regular heart rate, like most Aflutter.   Lead-3 showed it very clearly (at an atrial rate of 240-300bpm).  A single lead Kardia mobile was useless but, if I had it, a six lead would have given me information early that even idiot ER cardiologists missed. If it was so simple, how did every ER cardiologst miss it?  Many times?

No, I'm not saying that one should self-diagnose but if a Kardia Mobile is useful for detecting Afib, which is easily felt, a 6-lead Kardia Mobile is certainly useful for detecting other arrhythmias.  It takes a little work but it's really not hard, particularly if your EP shows you what to look for. Sure, one should get an EP involved but like AF patients, one can send 6-lead EKG strips to LiveCor to interpret or email to their EP.

In short, a 6-lead Kardia Mobile is every bit as useful as a single lead, for those with arrhythmias other than simple AF.

Youtube clip

by WazzA - 2020-05-28 14:34:49

Hope this is of help to anyone thinking of buying a Kardia Mobile! 

https://www.youtube.com/watch?v=JYdc4cjiWkg

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