CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

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.

Strengths

  • 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

Limitations

  • 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.

Categories: Electrophysiology
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