Remote cardiac monitoring puts a phone on heart
The number of deaths led by cardiovascular disease has occupied a quarter of the global death toll led by diseases. Cardiovascular disease always occurs suddenly. It is generally accepted that death resulting from cardiovascular disease always happens outside hospitals not inside hospitals. Thus, how do we care our heart under certain circumstances without monitoring of cardiovascular physicians? Remote cardiac monitoring device has been widely expanded to field of healthcare from simple medical behavior. Remotely monitoring impulse of heart is the same that a phone is put on heart.
Real-time transmission of abnormal ECG
Patients with cardiovascular disease should be attached importance to any time the year. Once remote cardiac monitoring center in QiLu Hospital happened to treat a patient who was female of fifty-six years old and has suffered from Old inferior wall myocardial infarction for more than three years. He had a suddenly syncopal attack at twenty-two o'clock one day.
Luckily, the patient wore iHolter at physicians' advice before the syncopal symptom occurred. iHolter is a remote cardiac monitoring device which is the same as the size of phone and worn at waist level and could automatically transmit abnormal ECG. Thus, once the patient fainted, the abnormal ECG was sent to remote cardiac monitoring center.
As a high-incidence disease in clinic, cardiovascular disease always occurred suddenly and unconsciously with very bad consequence.
The remote cardiac monitoring technology is aimed to provide patients with cardiovascular disease and high-risk patients with remote cardiac monitoring service and health management outside hospitals. As an innovative technology in clinical field, the remote cardiac monitoring technology could be compared to eagle eye on the tennis court and reflect real-time variation of heart. It is considered to reduce threat of sudden cardiovascular disease on life in clinic.
The journalists recently observed clinical process of this technology in remote cardiac monitoring center in QiLu Hospital of ShanDong University. As established in 2005, the remote cardiac monitoring center was a first in Asian.
As the buzzing sound was heard, a form of abnormal ECG appeared on the computer screen of medical staffs performing real-time monitoring service. The vice director of this monitoring center Wei Min said “this real-time data was transmitted from an inpatient named Feng in the People's Hospital of Meng Yin.
“Once automatic warning started, the monitoring device could read ECG data during 36 seconds around this time point and transmit the data to monitoring center. “Said by Gao Haiqing, a vice director of Qilu Hospital. By analyzing the abnormal ECG, the patient was found to have heart arrest of 3.3 seconds. Medical staffs immediately contacted with the patient's physician and informed him or her to watch this patient anxiously.
Decreasing deaths, reducing expense.
According to clinical data, the global number of deaths led by cardiovascular disease had reached 15,300,000 in 2004, occupying a quarter of the global death toll led by diseases. The incidence of hypertension in China was 10,000 cases per day, similar with the incidence of coronary disease. The predictive data showed that he global number of deaths caused by cardiovascular disease would increase to 25,000,000, among which 19,000,000 deaths occurred in the developing countries.
Taking predictive measures could reduce half of death. Early detecting abnormal symptoms and giving prompt treatment could not only reduce mortality and disability, but also greatly decrease medical expenses. The annual medical expense of cardiovascular disease has reached into 1,300,000,000,000 RMB according to data from Chinese Report of Cardiology in 2005. The other view clinically accepted is that medical expense after disease occurs is 4~8 times higher than medical expense of disease prevention.
In Fang Pihua' point the current remote cardiac monitoring technology could make accurate diagnosis for more than 95% arrthymia events including sinus rhythm, sinus tachycardia, atrial premature beat, supraventricular tachycardia, atrial flutter, atrial fibrillation, ventricular premature beat, intermittent atrioventricular block, ventricular fibrillation and ventricular pre-excitation. Meanwhile, it also assists clinical screening of coronary disease and facilities etiological diagnosis of palpitation, chest stuffiness and syncope.
While a entrepreneurs of Shan Dong province went to Europe for business, his remote cardiac monitoring device showed abnormal ECG, but he was' t conscious of any discomfort in his heart. As soon as he returned from Europe, Qilu Hospital performed heart examination for him and found that he had suffered from myocardial ischemia.
Since the Hospital of Hangzhou Normal University began to run the remote cardiac monitoring system in March, 2011, monitoring terminals has been established in 12 community health service stations in Gonghu District, Hangzhou. The vice director of this hospital Zhang Xingwei thinks that it may be difficult for community physicians to make diagnosis only by ECG and this may easily cause misdiagnosis. However, this monitoring system greatly reduces occurrence of misdiagnosis and referral. Clinical practice of Gao Haiqing't team also showed that at least hundreds of high-risk patients got their lives saved by remote cardiac monitoring.
Perhaps, all the medical staffs believe that remote cardiac monitoring technology could create win-win situation. For patients, this technology partly solves problems of seeing doctors (home monitoring), reduces medical expense (in remote areas) and avoids misdiagnosis (syncope). For doctors, this technology could help doctors promptly understand patients' condition, find side effects and complications of various treatments, and reduce medical disputes. In the end, this technology helps nations increase health of all the people and reduce medical expenditure.
Common usage, deficient in promotion
Remote cardiac monitoring technology is suitable for all kinds of arrhythmia, ischemic heart disease, conduction disturbance, and monitoring during and after surgery. Meanwhile, it also applies to other fields including monitoring of high-risk patients during transit period, routine monitoring of high-risk populations, and monitoring and pre-warning of sub-health populations and cadres populations.
“Chinese develop and research report of remote cardiac monitoring in 2011“ showed that we had developed our own remote cardiac monitoring device except products imported from America during 1993~2005. This device had been widely used in outpatient service and health care in 25 provinces. Nearly millions of people had used this device. Since 2006, the remote cardiac monitoring technology had expanded to various fields including blood pressure, blood sugar, sleep and respiratory monitoring. The transmission mode of this technology had changed from wired telephone transmission to wireless phone transmission and network transmission. The monitoring objects had extended from large hospitals to the grassroots medical institutions, from medical behavior of heart monitoring to preventive behaviors of healthcare.
The data from previous research indicated that there are 8 remote cardiac monitoring centers opening 24 hours and 50 enterprises engaged in research and development of this technology and owning products in China. But compared with prospect generally forecasted, some monitoring centers and enterprises are still under deficit.
Fang Pihua thought it necessary to overcome some problems according to the current development situation of remote ECG monitoring technology. For example, the judgment could not be made only by one-lead ECG and must be combined with clinical situation. Furthermore, the medical expenses were relatively expensive.
It is said that it would cost 100 RMB one day within a week to receive remote cardiac monitoring service in monitoring center of Qilu Hospital. If service time is more than a week, the final cost will enjoy discounts of different amplitudes according to the length of service time. The general principle is that the longer time of receiving service, the final price is more preferential.
A staff in the monitoring center points out that detachment or loosens connection of electrode patch easily happen during remote ECG monitoring process. When ECG image is interfered or linear, patients are advised to recheck the situation of electrode patch and instructed to reattach or change electrode patch. In addition, too much sweating caused by severe activities will affect the quality of ECG, thereby to affect diagnosis results.