• ISSN 1674-8301
  • CN 32-1810/R
Volume 35 Issue 3
May  2021
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Article Contents
Qin Shen, Jianqing Li, Chang Cui, Xingyao Wang, Hongxiang Gao, Chengyu Liu, Minglong Chen. A wearable real-time telemonitoring electrocardiogram device compared with traditional Holter monitoring[J]. The Journal of Biomedical Research, 2021, 35(3): 238-246. doi: 10.7555/JBR.34.20200074
Citation: Qin Shen, Jianqing Li, Chang Cui, Xingyao Wang, Hongxiang Gao, Chengyu Liu, Minglong Chen. A wearable real-time telemonitoring electrocardiogram device compared with traditional Holter monitoring[J]. The Journal of Biomedical Research, 2021, 35(3): 238-246. doi: 10.7555/JBR.34.20200074

A wearable real-time telemonitoring electrocardiogram device compared with traditional Holter monitoring

doi: 10.7555/JBR.34.20200074
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  • Corresponding author: Jianqing Li, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu 211166, China. Tel: +86-25-86869011, E-mail: ljq@seu.edu.cn; Minglong Chen, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China. Tel: +86-25-68303818, E-mail: chenminglong2001@163.com
  • Received: 2020-05-18
  • Revised: 2020-11-04
  • Published: 2020-12-18
  • Issue Date: 2021-05-28
  • Arrhythmias are very common in the healthy populations as well as patients with cardiovascular diseases. Among them, atrial fibrillation (AF) and malignant ventricular arrhythmias are usually associated with some clinical events. Early diagnosis of arrhythmias, particularly AF and ventricular arrhythmias, is very important for the treatment and prognosis of patients. Holter is a gold standard commonly recommended for noninvasive detection of paroxysmal arrhythmia. However, it has some shortcomings such as fixed detection timings, delayed report and inability of remote real-time detection. To deal with such problems, we designed and applied a new wearable 72-hour triple-lead H3-electrocardiogram (ECG) device with a remote cloud-based ECG platform and an expert-supporting system. In this study, 31 patients were recruited and 24-hour synchronous ECG data by H3-ECG and Holter were recorded. In the H3-ECG group, ECG signals were transmitted using remote real-time modes, and confirmed reports were made by doctors in the remote expert-supporting system, while the traditional modes and detection systems were used in the Holter group. The results showed no significant differences between the two groups in 24-hour total heart rate (HR), averaged HR, maximum HR, minimum HR, premature atrial complexes (PACs) and premature ventricular complexes (PVCs) (P>0.05). The sensitivity and specificity of capture and remote automatic cardiac events detection of PACs, PVCs, and AF by H3-ECG were 93% and 99%, 98% and 99%, 94% and 98%, respectively. Therefore, the long-term limb triple-lead H3-ECG device can be utilized for domiciliary ECG self-monitoring and remote management of patients with common arrhythmia under medical supervision.


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  • [1]
    Zhou ZQ, Hu DY. An epidemiological study on the prevalence of atrial fibrillation in the Chinese population of mainland China[J]. J Epidemiol, 2008, 18(5): 209–216. doi: 10.2188/jea.JE2008021
    Munger TM, Wu LQ, Shen WK. Atrial fibrillation[J]. J Biomed Res, 2014, 28(1): 1–17. doi: 10.7555/JBR.28.20130191
    Morin DP, Bernard ML, Madias C, et al. The state of the art: atrial fibrillation epidemiology, prevention, and treatment[J]. Mayo Clin Proc, 2016, 91(12): 1778–1810. doi: 10.1016/j.mayocp.2016.08.022
    Wang TJ, Larson MG, Levy D, et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham heart study[J]. Circulation, 2003, 107(23): 2920–2925. doi: 10.1161/01.CIR.0000072767.89944.6E
    Ng GA. Treating patients with ventricular ectopic beats[J]. Heart, 2006, 92(11): 1707–1712. doi: 10.1136/hrt.2005.067843
    Xu WH, Li MF, Chen ML, et al. Effect of burden and origin sites of premature ventricular contractions on left ventricular function by 7-day Holter monitor[J]. J Biomed Res, 2015, 29(6): 465–474. doi: 10.7555/JBR.29.20150032
    Poon K, Okin PM, Kligfield P. Diagnostic performance of a computer-based ECG rhythm algorithm[J]. J Electrocardiol, 2005, 38(3): 235–238. doi: 10.1016/j.jelectrocard.2005.01.008
    Sampaio SMV, Craveiro NM, Darrieux F, et al. Accuracy of the pacemaker event recorder versus Holter-ECG to detect both symptomatic and asymptomatic ventricular arrhythmias[J]. J Cardiovasc Electrophysiol, 2018, 29(1): 154–159. doi: 10.1111/jce.13370
    Joshi AK, Kowey PR, Prystowsky EN, et al. First experience with a Mobile Cardiac Outpatient Telemetry (MCOT) system for the diagnosis and management of cardiac arrhythmia[J]. Am J Cardiol, 2005, 95(7): 878–881. doi: 10.1016/j.amjcard.2004.12.015
    Olson JA, Fouts AM, Padanilam BJ, et al. Utility of mobile cardiac outpatient telemetry for the diagnosis of palpitations, presyncope, syncope, and the assessment of therapy efficacy[J]. J Cardiovasc Electrophysiol, 2007, 18(5): 473–477. doi: 10.1111/j.1540-8167.2007.00779.x
    Ritter MA, Kochhäuser S, Duning T, et al. Occult atrial fibrillation in cryptogenic stroke: detection by 7-day electrocardiogram versus implantable cardiac monitors[J]. Stroke, 2013, 44(5): 1449–1452. doi: 10.1161/STROKEAHA.111.676189
    Rothman SA, Laughlin JC, Seltzer J, et al. The diagnosis of cardiac arrhythmias: a prospective multi-center randomized study comparing mobile cardiac outpatient telemetry versus standard loop event monitoring[J]. J Cardiovasc Electrophysiol, 2007, 18(3): 241–247. doi: 10.1111/j.1540-8167.2006.00729.x
    Reiffel JA, Schwarzberg R, Murry M. Comparison of autotriggered memory loop recorders versus standard loop recorders versus 24-hour Holter monitors for arrhythmia detection[J]. Am J Cardiol, 2005, 95(9): 1055–1059. doi: 10.1016/j.amjcard.2005.01.025
    de Asmundis C, Conte G, Sieira J, et al. Comparison of the patient-activated event recording system vs. traditional 24 h Holter electrocardiography in individuals with paroxysmal palpitations or dizziness[J]. EP Europace, 2014, 16(8): 1231–1235. doi: 10.1093/europace/eut411
    Barrett PM, Komatireddy R, Haaser S, et al. Comparison of 24-hour Holter monitoring with 14-day novel adhesive patch electrocardiographic monitoring[J]. Am J Med, 2014, 127(1): 95.e11–95.e17. doi: 10.1016/j.amjmed.2013.10.003
    Haberman ZC, Jahn RT, Bose R, et al. Wireless smartphone ECG enables large-scale screening in diverse populations[J]. J Cardiovasc Electrophysiol, 2015, 26(5): 520–526. doi: 10.1111/jce.12634
    Lowres N, Neubeck L, Salkeld G, et al. Feasibility and cost-effectiveness of stroke prevention through community screening for atrial fibrillation using iPhone ECG in pharmacies: the SEARCH-AF study[J]. Thromb Haemost, 2014, 111(6): 1167–1176. doi: 10.1160/TH14-03-0231
    Doliwa Sobocinski P, Anggårdh Rooth E, Frykman Kull V, et al. Improved screening for silent atrial fibrillation after ischaemic stroke[J]. EP Europace, 2012, 14(8): 1112–1116. doi: 10.1093/europace/eur431
    Tung CE, Su D, Turakhia MP, et al. Diagnostic yield of extended cardiac patch monitoring in patients with stroke or TIA[J]. Front Neurol, 2015, 5: 266. doi: 10.3389/fneur.2014.00266
    Kumar A, Komaragiri R, Kumar M. From pacemaker to wearable: techniques for ECG detection systems[J]. J Med Syst, 2018, 42(2): 34. doi: 10.1007/s10916-017-0886-1
    Terbizan DJ, Dolezal BA, Albano C. Validity of seven commercially available heart rate monitors[J]. Meas Phys Educ Exerc Sci, 2002, 6(4): 243–247. doi: 10.1207/S15327841MPEE0604_3
    Friesen GM, Jannett TC, Jadallah MA, et al. A comparison of the noise sensitivity of nine QRS detection algorithms[J]. IEEE Trans Biomed Eng, 1990, 37(1): 85–98. doi: 10.1109/10.43620
    Liu FF, Liu CY, Jiang XG, et al. Performance analysis of ten common QRS detectors on different ECG application cases[J]. J Healthc Eng, 2018, 2018: 9050812.
    Bumgarner JM, Lambert CT, Hussein AA, et al. Smartwatch algorithm for automated detection of atrial fibrillation[J]. J Am Coll Cardiol, 2018, 71(21): 2381–2388. doi: 10.1016/j.jacc.2018.03.003
    Lau JK, Lowres N, Neubeck L, et al. iPhone ECG application for community screening to detect silent atrial fibrillation: a novel technology to prevent stroke[J]. Int J Cardiol, 2013, 165(1): 193–194. doi: 10.1016/j.ijcard.2013.01.220
    Chan PH, Wong CK, Pun L, et al. Head-to-head comparison of the AliveCor heart monitor and microlife WatchBP office AFIB for atrial fibrillation screening in a primary care setting[J]. Circulation, 2017, 135(1): 110–112. doi: 10.1161/CIRCULATIONAHA.116.024439
    Wang R, Blackburn G, Desai M, et al. Accuracy of wrist-worn heart rate monitors[J]. JAMA Cardiol, 2017, 2(1): 104–106. doi: 10.1001/jamacardio.2016.3340
    Gillinov S, Etiwy M, Wang R, et al. Variable accuracy of wearable heart rate monitors during aerobic exercise[J]. Med Sci Sports Exerc, 2017, 49(8): 1697–1703. doi: 10.1249/MSS.0000000000001284
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