Portable ECG

To any pacemaker Dr. specialist:

my father (76 yrs. old) has a pacemaker since last July. I am wondering if it fine to buy him one of the portable handheld ECG devices. He is a retired surgeon in Latin America so he will understand ECG. However, I am not sure if this is safety at all.

The products that I am talking about are: ReadMyHeart Handheld ECG, InstantCheck, etc.

Some of these allow the use of lead and no need to place the device on the chest.

Please let me know, I am interested in buying one if it is safe.

Thanks and I will be very grateful for your comments.

Ivan Lopez

6 Comments

ECG Concerns

by ElectricFrank - 2012-10-01 01:10:34

For an ECG to show the whole picture for your father it needs to be pacemaker compatible. This requires a wider bandwidth and pacer pulse detection circuitry. It's possible the ECG you mention has these capabilities, but you need to be sure.

There is no direct concern with safety other than the possibility of making decisions based on an ECG that doesn't show the whole picture. As an example when I developed a problem with my heart not responding to the pacer (lack of capture) my own prototype ECG showed the ventricular pacing pulses but no response from my heart. That pin pointed the problem as either too low pacing voltage (which ws the probem) or my heart developing a deadly problem. If it had showed no pacer pulses then the problem was most likely the pacemaker itself or bad sensing leads. A low quality or old model ECG wouldn't have shown the pacer pulses.

I just looked at the ReadMyHeart Handheld ECG and nothing is mentioned in the specs about handling a pacemaker.

frank

RE: ECG Concerns

by ivanlopez - 2012-10-01 04:10:04

Dear Frank:

thank you so much for your comments. I really appreciate them.

If you think that safety is not an issue, I will probably buy it. The reason is that besides the pacemaker, my father has been experiencing extrasistole which seems to be unrelated to the pacemaker (according to some cardiologists that have seen him).

It was for this later reason that I thought in the portable ECG. BTW, I don't think these devices are pacemaker compatible (bandwitdth and pulse detection).

My concern was always the safety issue, but you are the second person who responded me with a similar comment.

Thank you so much and my best wishes for you and your health.

Ivan

ECG More

by ElectricFrank - 2012-10-02 01:10:40

You won't be able to see any relationship between the pacemaker and the extrasistole's unless the ECG can handle the pacer pulses.

One thing that can cause an extrasistole is having the pacing voltage to the chamber set way too high. The cardiologists and EP's will generally deny this. What they miss is that a high pacing voltage can irritate the heart wall, and the irritation then produces the errant beats. This isn't in their research so it doesn't exist.

frank

Ecg more more

by ivanlopez - 2012-10-02 09:10:10

Dear Frank

Again, thank you so much for your time. Your information is very relevant, but how to convince the cardiologist on this hypothesis is they do not understand it. Do you know any paper or journal that discusses the issue?
Or how to test for this? What parameter should be tested?

The pacemaker was implanted midJuly, and the extrasistole appeared on mid september. Btw, the engineers of the company checked the pacemaker last week and they said it was fine. Obviously, this doesn't mean that a voltage is not high for a particular individual.

Thanks for your time and care,

Ivan

Research

by ElectricFrank - 2012-10-03 01:10:19

I don't know of any papers on it. That's why I do as much of my own diagnosis as I can.

It's one of those vague things that are hard to study. I'm not totally sure about it myself, but it makes sense. Docs aren't interested in what makes sense, only what has been researched. Us engineers are the wild west.

One thing that might help is that the problem would only show up with pacing voltages at least in the 3 volt range, and higher would increase the chance. When I had my loss of capture they turned my ventricle pacing voltage up to 5 volts as a temporary emergency measure. I followed up in a few weeks and had it tested and adjusted down again. During the time it was up I had a slowly increasing incidence of PVC's.

frank

Thanks again

by ivanlopez - 2012-10-03 04:10:28

Dear Frank

thank you again for your suggestions.

In my father's case, the pacemaker has not be reprogrammed or anything yet. It was implanted and everything was fine for two months and suddenly the extrasistole appeared.

Because he is a surgeon he detected the extrasistole not with ECG but by talking the pulse himself. He found them one night and went to the ER and the ECG confirmed the same.

One cardiologist gave him some medicine and this is taking care of the extrasistole, but if doesn't take the medicine, it reappears.

Thanks again for your assistance,

Ivan

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