Portable devices for ECG recording Paediatric cardiology services

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Use of AliveCor Kardia in Paediatric Cardiac Patients

Background

The AliveCor Kardia (ACK) is a commercially available device + application designed for use on Android or Apple mobile phones. It permits acquisition of a single lead ECG.

See  https://shop.gb.alivecor.com/products/kardiamobile

The Leon Heart Fund has purchased 10 devices for use in paediatric cardiac patients under the care of the Children’s Heart Unit.

 

Proposed Use

It is proposed that selected patients will be issued with the ACK device in order to document their heart rhythm during periods of time when they are experiencing symptoms that may be due to heart rhythm disturbance.

 

Eligibility Criteria

  • The child is under the care of the Children’s Heart Unit (NHS patient)
  • The child or parent has a suitable mobile phone – it is anticipated that this will be used for children aged 8 years or more (phone readily available, child capable placing fingers/hands over the recording electrodes and acquiring a recording)
  • There are intermittent troublesome symptoms that are likely to be due heart rhythm disturbance
  • Standard ambulatory assessments have failed to show a diagnosis

 

Exclusion Criteria

  • Patients with syncope – an implantable loop recorder may be more suitable
  • Any child who would not be able to acquire a recording / activate the device (or whose parents would not be able to help them to)

 

Period of Issue

The device will be issued for a 3 month period in the first instance – if there are no symptoms or recordings in the 3 month period, the consultant will determine whether a further period of issue would be of benefit.

If a recording shows the diagnosis clearly, and plans are put in place for managing the rhythm abnormality, the device can be returned before the 3 months are up.

 

Signed Agreement

The parent/carer of the child will sign an agreement in which

  • They acknowledge receipt of the device
  • They agree to return the device either once the diagnosis is clear or after the 3 months have elapsed
  • They agree to use the device as instructed and to treat it with care
  • They agree that the name of the patient will be used in setting up the ACK account – this will ensure that any transmissions will have the patient name on them,

 

Recording and Transmission of Data

The parents will be required to save any recordings.

The parents will transmit the recording(s) to a generic specialist nurse email address paediatriccardiac.cns@wales.nhs.uk 

 

The parents will telephone a named individual (usually their named specialist nurse) that a recording/transmission has taken place.

 

Use of Transmitted Data

The CNS team will check the generic email account on a daily basis.

A transmitted recording will be printed and passed to the named consultant. If the named consultant is away, the recording will be shown to the on-call paediatric cardiologist – he or she will determine if immediate action needs to be taken.

Printed transmitted recordings will be filed in the patient record.

 

Return of Equipment Following Use

Once the agreed period has lapsed, the equipment will be returned to the Children’s Heart Unit.

The family may decide if they wish to delete the account held with ACK.