One of my patients has been on the cutting edge of personal cardiac monitoring devices and I asked him to share his recent experience with the QardioCore ECG strap. What he sent me is a fascinating description of how the device works (which is unique in this area) along with how it was crucial in diagnosing the cause of his recent symptoms. I’m sharing it below.
I’m a current patient of the Skeptical Cardiologist and have experienced recovery from 14 months of Atrial Fibrillation with Rapid Ventricular Response, and subsequent heart failure. While I haven’t had symptoms of heart failure or Atrial Fibrillation in over 6 months, as a former long-distance cyclist, I had been following the progress for the FDA approval of the QardioCore device since it was announced over a year ago. You can learn more about their device at https://www.getqardio.com/qardiocore-wearable-ecg-ekg-monitor-iphone/, but I’ve pasted text from their website here: (https://support.getqardio.com/hc/en-us/articles/115000257105-Electrocardiogram-ECG-EKG- )
“QardioCore is a clinical-quality wearable electrocardiogram
An ECG gives two major kinds of information. First, by measuring time intervals on the ECG, a doctor can determine how long the electrical wave takes to pass through the heart. Finding out how long the wave takes to travel from one part of the heart to the next shows if the electrical activity is normal or slow, fast or irregular. Second, by measuring the amount of electrical activity passing through the heart muscle, a cardiologist may be able to find out if parts of the heart are too large or are overworked. During an ECG, several sensors, called electrodes, capture the electrical activity of the heart.
QardioCore is ideal for health conscious individuals or those with known or suspected heart conditions to record their everyday ECGs, physical activity, sport performance and medical symptoms and share their data with their doctors. Medical professionals can use QardioCore to quickly assess heart rate and rhythm, screen for arrhythmias, and remotely monitor and manage patients who use QardioCore.
QardioCore should be only used in conjunction with professional medical advice, diagnosis, or treatment, and not as a substitute, or a replacement for it. Qardio creates products and services that conform to US quality, safety and security requirements for medical products, while delivering a modern user experience. QardioCore will begin selling in the US after receiving US Food and Drug Administration clearance.”
Unfortunately, the US FDA tends to move slowly, and we can only speculate as too why, but the device is not available for purchase here. However, I found a friend in France who purchased one for me and shipped me the device. It is not illegal for me to use the device here, but it is not allowed to be sold here in the US.
I use an Apple I-Phone 8Plus and have used both the AliveCor KardiaBand and the KardiaMobile found here (https://store.alivecor.com), and reviewed by the esteemed Skeptical Cardiologist in other posts as well. While I find it as a useful tool, my only dissatisfaction is that I want to passively monitor my heart during sporting activities and look for rhythm disturbances. While I’m no expert in either sporting activities or rhythm disturbances, I’ve completed some healthy reading and living on both subjects and have a general awareness of the topic.
The QardioCore device is simple to wear, comes with three belts that can be used and cleaned, and comes with a charging cable. Everything that the app, and the product does, seems to be accurately described on their web site, so I won’t cover off on details here. You can read more about it at this link: https://www.getqardio.com/qardioapp/ My only dissatisfaction with this device, and other blue tooth devices, has nothing to do with the device itself. Apple seems to randomly disconnect from Bluetooth devices with their phones. I don’t pretend to know the specific mechanisms for the problem, but my blue tooth devices for bicycling, music headsets, and heart monitoring have all been plagued with intermittent blue tooth connection problems. So, at times, I find myself having to restart their app to keep the device connected, which is a minor annoyance.
I also use the QardioArm product to measure and monitor my blood pressure and am satisfied with it as well.
What follows is my anecdotal experiences of September 26, 2018 through the present day and I agreed to write about them here, in case it provides useful insight to others in some way.
As a person with a short-term history of heart problems, I tend to capture a lot of data with my devices. I monitor things like heart rate variability, blood pressure, Alivecor Kardia readings, sleep history, etc. I make an active attempt to monitor my levels of stress, but I know for certain that I lead a stressful life. I work longer hours than I should, probably sleep less than I should, exercise less than I like and should, and medicate and pray far less than I should. So, I don’t want to imply that anything that happened is the fault of the medical system, bad blue tooth connections, bad medical care, or bad advice from the Skeptical Cardiologist or any other medical professional. I tend to listen well, learn well, but I don’t always act as I should. But, I’m responsible for my choices, my decisions, and I live with the results of my actions.
With that said, I was sitting at the office on Wednesday September 26th, 2018 and was working away without a care in the world. As a computer programmer, I’m very sedentary and enjoy my work. I was wearing my QardioCore ECG strap at the time because I’m a big believer in capturing baseline data for my general living and lifestyle. I believe this data was invaluable in my first episode of heart problems, but have no supporting evidence to support my claim. At around 8:58:42 AM, I felt somewhat bad, and felt my heart racing. I glanced over at my phone which was showing the ECG trace at the time and noticed what I believed was Atrial Flutter at the time. But, after about 20 seconds, the ECG trace returned to normal, and I felt fine again. I made a quick note of the time, because I was busy, and continued working for the day. The Quardio App provides no diagnostic information, so it doesn’t analyze and interpret ECG patterns like the Alivecor Kardia app does. When I arrived at home later that day, I went back to look at the ECG trace, as the Quardio App easily allows that through features of the App. When I found the point in time of the ECG, I became concerned immediately because I believe that I was seeing a pattern that I recognized as Ventricular Tachycardia, a condition that comes in many forms, and has many causes, but can be fatal if not properly treated. As my cortisol levels increased, I contacted Dr. Google and just quickly verified that I wasn’t completely nuts, although I acknowledge there may be some partial nuttiness there. While going through this process, I experienced another 4 second episode which only increased my anxiety levels. After contacting my wife and asking her to return home, and informing some family members, I felt it best that I should contact the Skeptical Cardiologist after hours for input on my problem. I hate to bother the doctor, as he is a busy man, but contacted his after-hours number. While the operator on the other end of the line wondered what kind of nut case I was, she kindly contacted the doctor who promptly called me on my cell phone. I had informed the kind doctor that I had the device about three weeks prior, so he was already aware that I had the QardioCore. I quickly informed the doctor that I believed I had experienced at least one but possibly two cardiac events. After briefly talking, I hung up the phone and texted him photos of the screens from the Quardio App, so he could see the ECG tracings. Here are the photos that I sent to the Skeptical Cardiologist via text:
I believe this tool is valuable in many ways, but I believe that it was helpful for the Skeptical Cardiologist, as it helped narrow our focus of blood tests, scans, and potential procedures to run in a faster than normal basis. Normally, if I had not had evidence (accurate or not), I would have had to schedule an appointment, or go to ER. At that point, they would have either ordered an event monitor for me to wear while I was away from the hospital, or they would have had to admit me. Since I had a past history of Atrial Fibrillation, which isn’t quite as serious, we would have been sent home with an event monitor and instructions to take it easy and continue to take meds. We would have run more blood work, and more scans, but the point is that we would have been more broadly focused, as we would have had to generally guess as to the nature of the event and narrow it down.
I recognize that this is one of the controversies that is active in clinical cardiology, as I listen to podcasts by Dr. John Mandrola and others regarding the latest cardio devices, procedures and research. I realize that many Cardiologists are not in favor of devices like these, because they lead to uninformed conclusions, which leads to unneeded stress on both patients and their stressed-out doctors and cardiologists. I’ve listened to both sides of the argument, and I have my own opinions that I won’t express here. I will just say that I believe that this device saved me time, possibly my life (as I don’t know what I don’t know, unless I know to look), and some time in hastening and narrowing my therapy choices.
I will say that my wife and I were extremely happy with the services provided by his staff, himself, his colleagues, and the hospital staff as well. While I am confident I may be considered a difficult patient by some, or many, they were very thorough and kind in their treatment and explanation of my treatment options.
I hope that my experience adds helpful insight to the discussion. I’m confident that the Skeptical Cardiologist will add to this post, with his views on the events I’ve discussed above. And, I believe he appreciates having a Skeptical Patient every now and then as well.
As The Skeptical Patient wrote, this device is not sold in the United States. Having seen it in action now, I’m eager to get my hands on one and evaluate it further. It could dramatically alter home arrhythmia monitoring. For this patient it was incredibly helpful. If any of my European or Australian readers has experience with it please let me know.
Qardio makes a stylish, accurate and portable home BP monitor that I’ve written favorably about here.
N.B. Featured image of man running on beach with QardioCore is not of my patient.