Alivecor Kardiamobile

accuracy

by Tracey_E - 2021-02-02 10:18:53

It's about accuracy, not safety. I would not recommend the average person getting one. Unless you have some dangerous condition that needs extra monitoring, it just a reason to focus too much on our hearts rather than moving on. JMHO, of course :o) 

Kardia Mobile

by Gemita - 2021-02-02 10:57:53

John,

Yes it is about accuracy since the manufacturers have not tested for use with a pacemaker, therefore on their website they mention it is not suitable for pacemaker patients.  That is not to say it cannot record a decent ECG which can then be sent to, and interpreted by, your EP/Cardiologist who will have a special knowledge of what to look for.  Paced ECGs will be more difficult to read for the untrained eye than an unpaced ECG but then we can always try to learn.

Actually my first cardiologist encouraged me to buy a Kardia Mobile before he implanted the Reveal Linq monitor.  He said they were excellent, but of course this was before I had my pacemaker.  But there are many members here who have Kardia Mobile and like them and take ECG strips with them to their doctors when they attend consultations.  You need only use them to record a symptomatic episode of an arrhythmia, so you can correlate your symptoms to an arrhythmia at a particular time and date.

In many ways I agree with Tracey though!!  The more equipment we have, the more likely we are to use them and to focus on our hearts and watch their every flutter, beat, skip, but on the other hand, if I were to get a home monitor John, I would go for the Kardia Mobile, especially the newer 6 lead one.  Slightly more expensive but worth it I think.  For now I will continue to use my hard working BP monitor, check my neck pulse and rely on my symptoms to tell me what rhythm I am in, the speed of the arrhythmia and when I need to seek help.  I know these measures won't let me down. 

The choice is yours John.

Update

by Gemita - 2021-02-02 11:30:00

John a friend who has a Kardia Mobile, with pacemaker, tells me that Kardia restricts to 5 diagnoses:  Normal, Possible AFib, Bradycardia, Tachycardia and Unclassified.  Unclassified is usually a mix of NSR and other arrhythmias.  It can help to change the settings from the default 30 seconds to 2-3 minutes and the filter from normal to enhanced to get a better ECG strip.  The new 6 lead device works with Apple and Android phones and tablets apparently, but please do your research before you buy one.

I'll have a think

by quikjraw - 2021-02-02 11:32:02

Thanks both 

I'll have another think about why I want one before diving in.

I am by my very nature interested in this sort of thing so it's more curiosity than anything.

Kind regards John

Partly FDA legal, partly pacing artefacts

by crustyg - 2021-02-02 11:37:11

I think part of it is the usual 'things our lawyers make us say' - because they don't want to spend even more money getting this subgroup (not their target market) through FDA approval.

But also, the pacing artefact can cause interpretation difficulties. With modern, bi-polar leads, the pacing spike is quite small - but I happened to glance at an ECG of mine from some time back, and you can clearly see the pacing spike.  IIRC, the vendor majors on their device's ability to detect and report on some common heart electrical abnormalities, and the pacing artefact can interfere with this.

FWIW, I have a PM, pulseox, pocket single-lead ECG machine, medical degree and I don't use any of them.  Well, perhaps the PM (I'm 100% atrial paced), and sometimes my brain.

Seriously though, there really is a risk of increasing anxiety by too much self-monitoring.  We've recently had some discussions here about NSVT - lots of healthy folk have these but have no idea that they have them - having a PM report showing them can be quite frightening.  A lot of the poor science and alarmist reporting about SARS-CoV-2 has terrorised folk to no useful purpose, and too much time staring at the Kardia device *might* do the same.

But don't let my personal opinion put you off.

But then crustyg . . .

by Gemita - 2021-02-02 12:10:35

we could say why do we want access to our pacemaker data.  Isn't this anxiety provoking too for some of us ??  Shouldn't we just be getting on with our lives and leaving all this monitoring stuff to our doctors after all?  They would prefer it that way I am sure.  Much less work for them, but would we feel as well?   Why is this Club here - because we need to understand what is going on and we need support.  No I think on balance monitoring is a good idea in all its forms, but we have to keep it under firm control and not to let it take over our lives.

All testing should have a goal

by crustyg - 2021-02-02 12:40:35

When I was teaching medical students about how to use diagnostic medical imaging and use of Pathology services, I was always reminding them of two questions: 1) what question is this test intended to answer, 2) what do you predict the result to be? (tests understanding of the patient's condition).

I don't have any issue with folk monitoring everything: my caution is that unless you know how to evaluate the information and have some plan about how to use the result, then it's likely that all that it does is waste resources and raise anxiety.

I was warned by my EP-doc that I'll end up in AFIb eventually, so that's about the only cardiac rhythm issue that I keep an eye out for.  The rest of the time I try to get on with living my life.  For many folk, the Kardia gadget is a great way to maintain surveillance for AFib - and I applaud that.  And if I can help someone understand something in their PM reports then that's good too.  My original post wasn't intended to be a 'Don't buy one' but to provide some information about why the vendor says 'Not suitable for PM patients.'  And I shared my personal experience with my gadgets.  Turns out that trying to take an ECG on my bike near the top of a mountain climb, with cycling gloves on, isn't easy or quick!  So my little pocket ECG gadget isn't as useful as I had hoped, but no matter.  It wasn't expensive.

Yes we need a reason to monitor

by Gemita - 2021-02-02 14:02:13

Thank you crustyg for your helpful reply.  Yes I agree to be meaningful all testing should have a goal.  

I have been diarying on the computer significant symptomatic episodes of my Afib since late 2016  (sad I know but useful since I keep a diary any way) and I have been able to analyse the data and I can see since my pacemaker implant (2018) my episodes, although still frequent, have reduced in frequency, duration and most importantly episodes have been less symptomatic, although I have acquired one or two additional arrhythmias as well.  

I use this information to correlate my symptoms with any significant arrhythmia events recorded by my pacemaker and this has been immensely helpful in identifying new arrhythmias and my technicians have been able to analyse the data recorded and provide more information based on my symptoms.  The question I intend to answer is:  are my Afib events increasing?   When this is clearly seen to be happening and my symptoms are affecting my quality of life, I will know the time will be right for an ablation.  Of course I could just rely on the number of mode switching events recorded by my pacemaker to determine the number of Afib episodes I am getting, but this wouldn’t give me the detail of my diary notes or help me to come to a decision based on my symptoms.  Keeping a diary has given me good feedback that my pacemaker and current treatment is still working reasonably well.  I often forget to monitor, so that must be a good sign!!

I can visualise you struggling crustyg with your ECG gadget when you reach the top of a mountain climb and I cannot imagine the ECG recording would be readable or of good quality!!  You would probably end up in A&E fearing the worse if you did manage to read it.

Anyway John, hope these posts help you to come to a decision on monitoring. Requires dedication and a purpose!!

Self-monitoring is fashionable

by IAN MC - 2021-02-02 14:18:02

and it really does amuse me !    I have been a member of a running / cycling club for over 40 yrs  and we all used to just   " go for it" . Our bodies told us when we could speed up and when we should slow down.

Now lots of otherwise sensible friends are wearing Fitbits, Garmins , Polar watches with chest-straps, Apple watches and Kardia devices . Have their marathon PBs improved, are they cycling better ?   Not at all , if anything the opposite is true !

" LISTEN TO YOUR BODY "   I say !  How you feel is what matters.( unless , and only if,  you've got good reason to monitor )

Ian

Listen to your body

by AgentX86 - 2021-02-02 16:03:51

That's great for 'normal" people but we're not talking about athlete wannabes  here. The questions they answer directly aren't all that important (any idiot can be trained to spot almost all variations of AF).  It's the things the KM can't diagnose that may be important.  

KM is highly recommended by many cardiologists and EPs, just to send records for analysis when symptoms occur.   They can quickly determine if there is reason for concern or it's just another episode of what's already known.  The KM can also be used to tell when drugs are needed, either pill-in-the-pocket or even anticoagulants.

Both of my doctors would like to see them when anything unusal occurs but that never happens anymore.  I know what my heart's doing.  ;-)  I gave my KM to my son, who was recently diagnosed with AF.

For the <$100 or $150 for the 6-lead, they're money well spent.  If we're going to fixate on something it might just as well ne something that gives us some real information.

Disagree with the exercise analogy

by quikjraw - 2021-02-03 08:05:25

I must say I disagree with the idea that monitoring data during exercise and using it wisely will not improve performance.

I'm not saying that on race day going for it will yield amazing results.

None of us are born with an in built gauge on how hard you should go in different stages of training.

The result is that people get injured or ill from over training or simply do not improve due to under training. 

If I was asked to go out and put in my maximum effort over 1 mile what would that even look like ? How would I know it was my maximum effort and not my mental maximum for that day without heart rate knowledge?

I'm with you Quickjraw

by crustyg - 2021-02-03 08:58:28

I always run + cycle with a heartrate strap.  I review my cycling performance against my HR - it's good objective data about how hard I've been trying, and useful to compare with my performance.  As I have SSS+CI there's no point worrying about %VO2MAX etc., but it's a good measure of whether I'm getting better, or simply older.

Quickjraw / Crusty ............. Yes, but

by IAN MC - 2021-02-03 09:50:33

Don't think I haven't been tempted by the technology !  i have a drawer full of various HR monitors / running watches which I eagerly bought,  then gave up on them .

Now the only technology I take with me when I run is my front door key !

I fully understand the theory that HR monitors can keep you in the right " training zones " , theoretically prevent overtraining and help monitor progress BUT I believe the whole concept to be fundamentally flawed.

On any given day , your HR does not necessarily match running effort. 

There are too many variables ...... dehydration /  stress / lack of sleep / the weather / blood lactate levels.    All of these can  have a marked effect on heart rate and therefore on athletic performance . I ran one marathon overseas on a hot humid day with that lovely runners excuse " I had nothing in my legs ". I should have listened to my body  and taken the next flight home !!

On a hot humid day your heart has to work harder during your run ; try telling that to the latest toy you have bought from Amazon !

As for your last  question , Quickjraw, why not  ask Roger Bannister how he ran a 4 minute mile in 1954 . He probably wore a watch though !

Seriously though, as we all know, the longest athletic distance is from the armchair to the front door and I do believe that buying an expensive gizmo increases one's incentive to make that journey which can  only be a good thing.

Cheers

Ian

I agree Ian...

by crustyg - 2021-02-03 11:18:23

I never do my exercise to any arbitrary target of HR or any other gadget (my Garmin Forerunner has GPS).  I listen to my body as Agent wisely says - in fact in the early days of owning the Forerunner I used to make myself estimate my pace *before* checking the gadget to start to learn what any particular pace actually felt like.  The tech was the objective measurement I used after I'd decided.  And on good days, a particular pace would feel easy.

For those interested in improving their performance, a log is essential - date/time, distance, elapsed time and how I felt about it.  Nothing better for the spirit than to complete a miserable feeling, cold, wet activity, and then, post-shower, check the objective data and realise that it was close to a PB or well within normal time for that training run/ride.  Massive boost to the confidence.

The tech is my equivalent of the post-exercise chat with Coach, and then matching how I felt - mind + body - against the time/metres climbed/HR data (for me, HR is a very accurate measure of effort as it's 100% controlled by my PM which is a deterministic system - constant inputs => constant, predictable output - HR).  As a human being I'm *not* deterministic.

Alivecor Kardia Device

by amanda_shanti - 2021-02-05 01:08:25

I have an Alivecor Kardiamobile EKG device (6-leads) and it's actually recommended to me by my cardiologist. I was having some funny sensations/weird feeling couple times and worry about it. After discussions with my doctor, she recommended me to turn the PM home monitor function on (which I still in consideration), so she has more information to analyse and in the same time I could also use the Kardia to record a EKG at the moment when I experience something abnormal. So that I could show her the EKG later in the follow up session. She did told me that the Kardia device is good but not as good as the data collect directly from the PM though.

Since it's indeed a very thin/small device, I keep it in my purse and with me most of the time. I do think it's quite handy when I have an odd sensation and want to record it for my doctor to peruse.

Alivecor Kardia Device

by PM1648 - 2023-09-28 18:55:40

I use the single channel KardiaMobile to track my rhythm and pacemaker activity.  AliveCor does not recommend KardiaMobile for pacemaker users.  I find that it is not able to detect when my demand pacemaker kicks in, but I have rudimentary ECG interpretation skills and can recognize pacemaker beats bc the R wave is wider than my intrinsic R wave.  I have found the KardiaMobile tracings quite helpful in getting to understand how often my pacemaker kicks in and whether occasional palpitations are related to pacemaker activity.  My conclusion is that if you are able to interpret your own ECG, the KardiaMobile has information to offer on your pacemaker's function but that if you cannot, save your money.  

I have also found a way to make the KardiaMobile a wearable device.  See below:

Patient-directed, home cardiac monitoring has been lauded by Apple, AliveCor and others for early detection of serious arrhythmias that may otherwise be detected only when irreversible impairment has already occurred.  There is a simple way of making the 1-channel KardiaMobile device wearable, which allows a user to take a recording without applying his or her fingers to the KardiaMobile pads. The modification consists of applying a disposable 3M Red Dot 2560 electrode to each of the 2 pads of the KardiaMobile.  One electrode is also applied just under the middle of the right clavicle and another to the left anterior chest at the V4 position.  A 20-inch lead with alligator clamps at each end is used to connect one of the electrodes on the Kardia Mobile to one of the 2 chest electrodes, and a second lead attaches the remaining Kardia electrode to the other chest electrode.  The attachment point for each alligator clip is the metal nub  in the center of the electrode.  Then the user runs the Kardia Mobile app in the usual fashion.  This inexpensive innovation allows the user to record ECGs without sitting down and applying fingers to the KardiaMobile pads.  However, the user must be stationary or moving slowly during the recording to avoid movement artifact.  The utility of the KardiaMobile is increased by this modification.  A similar adaptation would no doubt be possible with the 6-lead version of the KardiaMobile, but I have not attempted it.

KardiaMobile

by PM1648 - 2023-09-28 19:07:29

I meant to add a question to my previous comment on KardiaMobile use with pacemaker.  Has anyone who has used it with a pacemaker been able to see pacemaker spikes on the KardiaMobile tracing?  I believe that KardiaMobile filters out the pacemaker spikes with its high frequency filter.  

KardiaMobile

by PM1648 - 2023-09-28 19:15:02

Also to clarify my previous comments: I find that the KardiaMobile interpretation is not helpful in monitoring a pacemaker but that the KardiaMobile tracing is helpful providing the user has the ability to interpret his or her ECG.