First experience with a Mobile Cardiac Outpatient Telemetry (MCOT) system for the diagnosis and management of cardiac arrhythmia

doi:10.1016/j.amjcard.2004.12.015

The American Journal of Cardiology

Volume 95, Issue 7, 1 April 2005, Pages 878-881

https://doi.org/10.1016/j.amjcard.2004.12.015 Get rights and content

Recently, a mobile cardiac outpatient telemetry (MCOT) system has become available that monitors the electrocardiogram continuously, recognizes arrhythmias automatically, and transmits abnormal rhythms instantaneously. MCOT does not require activation by the patient. We report data from the first 100 consecutive patients monitored by this new technology.

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Cited by (86)

Continuous ECG monitoring versus mobile telemetry: A comparison of arrhythmia diagnostics in human- versus algorithmic-dependent systems
2021, Heart Rhythm O2
Citation Excerpt :
In the last 10 years there has been an explosion of both medical grade (ie, US Food and Drug Administration [FDA]-approved) and commercial grade ambulatory cardiac monitoring technologies (eg, watches, clothing, etc). Much of the industry’s focus has been on ease of use, duration of recording,1,2 and means of report delivery to the physician (ie, “real-time” vs not).3 Lost in the weeds is that a monitor that fails to capture and report significant arrhythmias may cause harmful clinical misdirection, and thus a comparative understanding of diagnostic accuracy and arrhythmia detection between monitors is of utmost importance.
Clinicians rarely scrutinize the full disclosure of a myriad of FDA-approved long-term rhythm monitors, and they rely on manufacturers to detect and report relevant rhythm abnormalities.
The objective of this study is to compare the diagnostic accuracy between mobile cardiac telemetry (MCT), which uses an algorithm-based detection strategy, and continuous long-term electrocardiography (LT-ECG) monitoring, which uses a human-based detection strategy.
In an outpatient arrhythmia clinic, we enrolled 50 sequential patients ordered to wear a 30-day MCT, to simultaneously wear a continuous LT-ECG monitor. Periods of concomitant wear of both devices were examined using the associated report, which was over-read by 2 electrophysiologists.
Forty-six of 50 patients wore both monitors simultaneously for an average of 10.3 ± 4.4 days (range: 1.2–14.8 days). During simultaneous recording, patients were more often diagnosed with arrhythmia by LT-ECG compared to MCT (23/46 vs 11/46), P = .018. Similarly, more arrhythmia episodes were detected during simultaneous recording with the LT-ECG compared to MCT (61 vs 19), P < .001. This trend remained consistent across arrhythmia subtypes, including ventricular tachycardia (13 patients by LT-ECG vs 7 by MCT), atrioventricular (AV) block (3 patients by LT-ECG vs 0 by MCT), and AV node reentrant tachycardia (2 patients by LT-ECG vs 0 by MCT). Atrial fibrillation (AF) was documented by both monitors in 2 patients; however, LT-ECG monitoring captured 4 additional AF episodes missed by MCT.
In a time-controlled, paired analysis of 2 disparate rhythm monitors worn simultaneously, human-dependent LT-ECG arrhythmia detection significantly outperformed algorithm-based MCT arrhythmia detection.
A review of patient-led data acquisition for atrial fibrillation detection to prevent stroke
2021, Biomedical Signal Processing and Control
In this paper we review devices that can be used in the home environment for Atrial Fibrillation (AF) detection. Detection and subsequent treatment of this heart rhythm disorder is an important strategy for stroke prevention, because AF increases stroke risk fivefold. The device review was carried out in two steps. In the first step, we have examined technology used, human factors, and cost. The findings were utilized to create a taxonomy of patient-led data acquisition systems. In the second step, we used that taxonomy to review practical stroke risk monitoring services. On a technical level, such services belong either to the signal recording or event trigger category. Signal recording systems deal with data which can serve as evidence for human decision-making. In contrast, event trigger systems address information which has a significantly lower data rate when compared with raw signal data. Another finding of our review is that a stroke risk monitoring service can either be directed at patients or at healthcare providers. Being directed at patients implies that the service is rendered by a health gadget which can only be used to raise a suspicion about the stroke risk. Only medical devices can direct their services at healthcare providers who must pay for data and information that can help with a diagnosis. Our investigation shows that patient-led data acquisition is a practical way to increase the measurement duration of physiological signals and thereby help to detect and treat more AF which might prevent stroke.
Ambulatory cardiac bio-signals: From mirage to clinical reality through a decade of progress
2019, International Journal of Medical Informatics
Health monitoring is shifting towards continuous, ambulatory and clinically comparable wearable devices. Telemedicine and remote diagnosis could harness the capability of mobile cardiac health information, as the technology on bio-physical signal monitoring has improved significantly.
The purpose of this review article is (1) to systematically assess the viability of ambulatory electrocardiography (ECG), (2) to provide a systems level understanding of a broad spectrum of wearable heart signal monitoring approaches and (3) to identify areas of improvement in the existing technology needed to attain clinical grade diagnosis.
Based on the included literature, we have identified (1) that the developments in ECG monitoring through wearable devices are reaching feasibility, and are capable of delivering diagnostic and prognostic information, (2) that reliable sensing is the major bottleneck in the entire process of ambulatory monitoring, (3) that there is a strong need for artificial intelligence and machine learning techniques to parse and infer the biosignals and (4) that aspects of wearer comfort has largely been ignored in the prevailing developments, which can become a key factor for consumer acceptance.
Cardiac health information is crucial for diagnosis and prevention of several disease onsets. Mobile and continuous monitoring can aid avoiding risks involved with acute symptoms. The health information obtained through continuous monitoring can serve as the BigData of heart signals, and can facilitate new treatment methods and devise effective health policies.
2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society
2019, Heart Rhythm
Bradyarrhythmias for the Internist
2019, Medical Clinics of North America
Citation Excerpt :
They are selected based on the frequency of the symptoms. They can be as short as 24-hour Holter monitors17–19 or as long as 4-week event monitors. Emerging newer technology based on smartphone applications is being used more frequently to establish symptoms/rhythm correlation.
2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: Executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society
2019, Heart Rhythm

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Brief reportsFirst experience with a Mobile Cardiac Outpatient Telemetry (MCOT) system for the diagnosis and management of cardiac arrhythmia

Am J Cardiol

Am J Med

Am J Cardiol

Remote recording of physiologic data by radio

Rocky Mountain Med J

Cardiovascular complaintsCorrelation with cardiac arrhythmias on 24-hour electrocardiographic monitoring

Chest

Cardiac event recorders yield more diagnoses and are more cost-effective than 48-hour Holter monitoring in patients with palpitations

Ann Intern Med

Brief reports
First experience with a Mobile Cardiac Outpatient Telemetry (MCOT) system for the diagnosis and management of cardiac arrhythmia