December 8th, 2012

ECG Screening via iPhone — Game Changer or Just a Game?

On my blog, Dr. Wes, I recently shared my experiences using AliveCor’s ECG Case for iPhone, for which I was a beta-tester. This device’s ease of use will, I think, make it a game changer for physicians and medically savvy patients. I have no commercial interest in AliveCor (frankly, I wish I did), so I share my thoughts with you here just as an honest observer.

Here, in brief, are what I consider to be the strengths and limitations of the device, which has now been approved by the FDA.


  • Ease of use (no technician), compelling design, handsome appearance
  • Real-time recording
  • Versatility of recording method (grasping electrodes by hand or placement of the device on the skin of the chest)
  • ECG tracings can be uploaded, sent, and stored in a variety of formats
  • My fellow physicians see it as a useful complement to the stethoscope
  • Instant differentiation of atrial fibrillation from premature atrial or ventricular beats (or even from atrial flutter with variable AV conduction)
  • The device can replicate most limb leads
  • Patients are transfixed by what the device shows them


  • Case could be sturdier
  • Alcohol prep may be needed for reading via placement on the skin
  • Recordings from the device cannot yet be easily incorporated into an electronic medical record
  • Single-lead device (multiple ECG leads are not collected simultaneously), so subtle indicators of a heart attack could be missed
  • Patient information, including demographics, must be entered manually (the biggest minus, in my opinion)
  • Ease of use outside a medical setting poses confidentiality challenges

As a member of the CardioExchange community, I am curious to hear your thoughts about how, if at all, this device will change practice.

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