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  • 1 Department of Cardiology, Hospitaller Brothers of St John of God Hospital, Budapest, Hungary
  • 2 ArguScan Ltd, Budapest, Hungary
  • 3 Árpád fejedelem út 7, H-1023, Budapest, Hungary
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Abstract

Introduction

In the current era of acute coronary interventions, patients who suffer a myocardial infarction (MI) are discharged either to home or to a rehabilitation facility very rapidly, after just a few days. Mortality, however, is highest during the first month after MI. Patients with decreased left ventricular systolic function who lost a significant percentage of their myocardium are at the highest risk. Given the advances of telemedicine, it may therefore be important to develop new methods of home arrhythmia monitoring for these patients.

Objective

To determine the reliability of an internet-based continuous home arrhythmia monitoring during the first month after discharge in patients with decreased left ventricular function who suffered an acute MI and underwent coronary intervention.

Methods

Numerous telephone-based ECG monitoring systems exist but the authors present their experiences with a new technology involving continuous internet-based ECG monitoring which does not require activation by the patient. A mobile internet-based device was developed for patients who had no access to internet.

Results

We monitored 10 post-MI patients with an ejection fraction of less than 40% who were discharged home. Cumulative monitoring time was 170 days. The completely noise-free and error-free ECG periods amounted to 98 % and 99%, respectively. Average time to response to the 66 alarms raised was 27 seconds. The average number of alarms per day was 0.39 while the positive predictive value was 0.106. Total alarm time was 29.8 minutes which works out to 10.5 seconds per day.

Conclusions

As the unique chest band we developed makes it possible to record error-free ECGs during most of the monitoring period, our method appears to be suitable for home monitoring of patients discharged from hospital. The low alarm time means that many patients can be monitored simultaneously without compromising patient safety.

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