G383 Use of smart phone ecg recorder for a quicker outpatient diagnosis and management of palpitations in children – a dgh experience of 18 months. (May 2019)

• Record Type: Journal Article
• Authors: Kumar, MR; Suryanarayanan, B; Hooper, K; Brady, A; Kang, H
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 2
• Page Start: A156
• Page End: A156
• Publication Date: 2019-05
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-rcpch.369
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: To establish whether the use of the Kardia smartphone ECG recorder allows a quicker diagnosis to be made in the management of children with palpitations. Palpitations in children are a common cause of referral to outpatient paediatrics. Most of these are benign but can cause a lot of concern. As these episodes are often short-lived and paroxysmal, it is difficult to record an ECG during the episode and thereby rule out a significant cardiac arrhythmia. Methods: A retrospective notes review of 61 patients from a single large district general hospital, from November 2016 to May 2018, who were loaned a Kardia device. We assessed the use of Kardia Smart phone app from Alivecor for patients to record an ECG during an episode of palpitations and then send it on for review. Results: Total of 61 patients were offered Kardia device for the investigation of palpitations. Five were excluded as the Kardia was given for reasons other than palpitations. One set of notes couldn't be traced. In total 55 patients were included in this analysis. Of the total number of patients 23 were asymptomatic and the device was not used. Of the 32 symptomatic patients 3 had SVT and 29 had sinus rhythm or a sinus tachycardia and were reassured. Of note all 32 patients recorded ECGs were interpretable: 28/32 were of a good quality. Of the 32 patients who were symptomatic 15 were discharged after the first appointment and only 17 had follow ups booked which were mostly for reassurance. Only 17 Holter ECGs requested. Pre Kardia most would have had a Holter Conclusion: The Kardia Mobile ECG device use has significantly improved the time required to make a diagnosis in children presenting with palpitations. There was a lesser requirement to undertake Holter ECG monitoring and fewer patients were followed up. Many of these patients were discharged following reassurance without the need for any further investigation.