In the recently published RedHeart Study the Coala Heart Monitor was used to remotely monitor 821 women with palpitation issues for 60 days. Over 200,000 individual ECG strips were analyzed. The direct ECG response of the Coala Heart Monitor contributed to reduced levels of anxiety, depression and symptoms of palpitations. The direct ECG response of the Coala also led to an increased quality of life (HRQOL).
The RedHeart-study was led by Carina Carnlöf, PhD Karolinska Institute and Registered Nurse at the Karolinska University Hospital, Stockholm, Sweden.
Dr. Carnlöf, tell us about the RedHeart-study and why the findings are important?
In one of my research projects as part of my dissertation, I found that women with paroxysmal supraventricular tachycardias (PSVT’s) had to wait in average six years longer than men to be referred on for ablation. Our results were unfortunately not the first reported on this issue, and we began to think about how many women with palpitations were missed with these diagnoses.
The problem with PSVT is that the palpitation most often is temporary and intermittent and unable to be recorded on an ECG in the doctor’s office. With a portable heart monitor, you can hopefully catch your heartbeats in everyday life and have the ability to share it with your physician.
The RedHeart study only included female patients with PSVT and atrial fibrillation (AF) as research has found that women are more symptomatic, have a lower quality of life, and are treated with interventions such as cardioversion, catheter ablation, or antiarrhythmic drug therapy less frequently than men.
What do you see as the most important conclusions of the RedHeart study?
It is important to listen to the patient. Getting a diagnosis or just finding out that there is nothing wrong can reduce anxiety and hopefully it can be easier to live with their symptoms.
It certainly helps to give an added feel of security by being able to record your heart rhythm when rhythm irregularities occurs and be able to get an immediate result. The Coala differs from other devices on the market because of the instant response and by reducing worries and anxiety related to palpitations, there is ability to help to decrease the need of unnecessary admissions to primary care and emergencies.
The RedHeart findings suggest that direct ECG feedback improves a patient’s sense of control, security, and empowerment when experiencing palpitations. Empowerment is a concept often used in patient-centered care. Healthcare professionals should facilitate processes where patients are encouraged to become active participants in their own care. By offering portable ECG recording devices to patients who experience palpitations, healthcare providers can demonstrate that they are taking their patients’ concerns seriously and want to help them find a way to deal with their symptoms.
What clinical implications do you see from the study?
This was the largest study of its kind and we could show with statistical significance that instant analysis of the ECG with direct response during palpitations decreases symptoms, anxiety, depression, and increases HRQOL. We could also show that palpitations in women are seldom caused by arrhythmias of clinical importance.
By using new digital solutions, it was possible to enroll a large number of study participants with efficient data collection from both metropolitan and rural areas.
Hopefully, the results can lead to improved patient care for the many women that suffer from palpitations!
For an abstract and summary, see here.