Rise of the smart device ECG and what it means for the general cardiologist

This article summarizes a review published in the British Medical Journal in 2019.

Ambulatory electrocardiogram (ECG) monitoring is currently the most commonly used diagnostic method for paroxysmal arrhythmia. However, due to the infrequent nature of these arrhythmias, this ECG monitoring tool is cost-inefficient and can delay diagnosis. Smartphone-based ECG devices like AliveCor’s Kardia products have secured a foothold in the public market. The evidence available on AliveCor’s FDA-cleared Kardia products and their adoption by the general public have recently put these products in cardiologists’ radars.

AliveCor’s Kardia products are user-friendly and portable. These FDA-cleared devices are capable of producing medical-grade single-lead or six-lead ECG readings. A user records their ECG using pocket-friendly electrodes, and the ECG readings can then be viewed in a downloaded application on the smartphone screen. The application classifies the ECG as normal sinus rhythm, possible atrial fibrillation, unclassified, or unreadable. AliveCor’s Kardia device uses an algorithm that is capable of yielding an atrial fibrillation diagnosis with 98% sensitivity and 97% specificity. Users can send their ECG readings securely to their doctors via email for further interpretation.

What do these tools mean for the general cardiologist?

These cutting-edge devices can potentially lead to significant improvements in the clinical management of atrial fibrillation, as  pointed out by the bulk of evidence base behind the use of AliveCor’s products. For example, the well-publicized REHEARSE-AF trial, which involved a cohort of 1,001 patients, showed that more patients in AliveCor device intervention group were diagnosed with atrial fibrillation compared with those in the control group who only received standard of care. Additional studies have also shown that AliveCor’s ECG devices were likely to be feasible for use in atrial fibrillation screening programs and have reported high patient satisfaction scores. Research studies have also reported the use of AliveCor’s devices in QT interval monitoring

To manage high-risk patients with infrequent arrhythmia symptoms like supraventricular tachycardia, cardiologists may benefit from formally incorporating AliveCor’s ECG devices into their routine patient monitoring. These devices have the potential to promote patient-led care and reduce the burden on cumbersome ambulatory ECG use.


#1. What is the specificity of KardiaMobile?