New real-time loop recorder diagnosis of symptomatic arrhythmia via telemedicine.

Background: One disadvantage of current loop recorders is the long interval between recording an electrocardiogram (ECG), establishing a diagnosis, and taking appropriate medical measures. The Cardio R loop recorder transmits cardiac recordings by cellular communication at the push of a button. Users can concomitantly relay symptoms, thereby providing a symptom/cardio-rhythm correlation.

Hypothesis: The Cardio R is capable of early detection of cardio-electrical events that could account for patients' symptoms.

Methods: This observational study was designed to evaluate patients who were referred from community physicians/cardiologists for evaluation of various cardiac symptoms that were not observed by regular office ECGs or traditional 24-hour Holter cardiac monitoring. Transmitted recordings were instantly displayed on a monitor for immediate diagnosis by the on-duty medical team at SHL-Telemedicine's call center. Abnormal tracings, especially when accompanied by symptoms selected from the prepared list, enabled the staff to instruct the subscriber, notify their physician, and/or dispatch a mobile intensive care unit to the scene.

Results: Between January 2009 and August 2010, there were 17 622 ECG transmissions received from 604 patients (age range, 10-95 years) who completed a 1-month trial with the Cardio R device. Palpitation, presyncope, and chest pain were the leading complaints. A disturbance in rhythm that could account for symptoms occurred during recording in 49% cases and was displayed within 7 minutes in 93% of them. No longer than 2 days elapsed from recording onset to diagnosis.

Conclusions: The Cardio R device enables prompt ECG confirmation/exclusion of a probable arrhythmic cause of symptoms, enabling rapid intervention for cardiac-relevant complaints.