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Tan BY, Ho KL, Ching CK, Teo WS
Correspondence: Dr Tan Boon Yew, email@example.com
Introduction Arrhythmias are often intermittent, and a normal electrocardiogram (ECG) may not be diagnostic. The purpose of this study was to evaluate the usefulness of HeartWave500 (HW), a novel web-based ambulatory ECG monitoring device.
Methods A total of 120 patients from the National Heart Centre, Singapore were prospectively randomised in a three to one ratio to either HW or a standard transtelephonic (TT) event recorder. HW records five leads and transmits to an internet server, while TT transmits audio data to a central station. Monitoring was conducted for two weeks. The diagnostic yield was calculated in two ways: the percentage of patients successfully diagnosed as a function of time, and the absolute number of new diagnoses per patient per week.
Results 33 patients (14 male, 19 female; mean age 49.6 +/- 11.1 years) were randomised to TT. 87 patients (32 male, 55 female; mean age 43.7 +/- 12.2 years) were randomised to HW. At the end of two weeks, the percentage of patients diagnosed with any arrhythmia was similar for both groups (66.7 percent for TT versus 67.8 percent for HW). There was a trend toward significance for the number of diagnoses per patient per week for Week 2 between TT and HW (0.58 +/- 0.75 versus 0.34 +/- 0.55, p is 0.06). Transmitted ECGs were read earlier for HW (18 minutes vs. 1107 minutes, Mann-Whitney non-parametric test, p is less than 0.05). Transmitted recordings that were unreadable were also significantly lower for HW (8.0 percent vs. 17.6 percent, chi-square test, p is less than 0.05).
Conclusion HW and TT have similar diagnostic yields. There is a trend toward a shorter monitoring time for HW. The ability of HW to record and transmit via the web, the earlier review of data and low unreadable data make HW an attractive alternative to TT.
Keywords: arrhythmia detection, HeartWave500, transtelephonic event recorder, web-based monitoring
Singapore Med J 2010; 51(7): 565-569