A novel approach for heart rhythm disorder screening on primary healthcare level using a Personal Digital Mobile Sensor in Slovenia: a pilot study (Preprint)

Abstract

Heart rhythm disorders affect millions of people annually. The diagnosis usually depends on the electrocardiogram (ECG) record, but a single record does not necessarily reflect the real situation. Continuous methods are rarely accessible at the primary healthcare level. Considering the severity and costs of the diagnostic approach, a cheaper, but reliable, continuous monitoring system for heart rhythm disorders is needed.

The goal was to analyse the usefulness of telecardiology in the primary health care level. With the help of a patient's history of rhythm disturbance and an ECG scan using an ECG personal sensor (ECG PS), we wanted to evaluate the satisfaction of patients and their physicians with the use of an ECG sensor treatment at the primary level. We also wanted to evaluate the cost-effectiveness of this tool at the primary level and develop a clinical pathway for treating patients with rhythm disorders at the primary health care level.

The Jožef Stefan Institute developed a personal portable ECG sensor that works with a smartphone, which was used in our pilot study. We included patients with a history of suspected rhythm disturbance who visited their family physician at the Healthcare Center Ljubljana and Healthcare Center Murska Sobota from October 2016 to January 2018.

After the ECG sensor measurement and first checkup at a family physician, the study found that there was no statistical significant difference in the number of present rhythm disorders and actions taken to treat patients with either observation or administration of a new drug. However, there was a statistically significant difference in the number of patients being referred to a cardiologist (p < 0.001).

The use of an ECG sensor allows family physicians to confirm an accurate diagnosis and helps them distinguish between patients who need to be referred to a cardiologist as soon as possible and those who can be treated by primary healthcare providers. This method is also readily applicable and useful for both physicians and patients because it shortens the time in starting the treatment and reduces unnecessary cost.