Study On Clinical Application Of A Portable Remote Real-time Electrocardiogram Monitoring System

Cardiovascular disease is a major public health concern, as it represents the leading cause of morbidity and mortality in the world. Then, the burden of cardiovascular diseases is one of great concern to patients and the health-care system. Due to characteristics of cardiovascular disease, pre-hospital establishment of the diagnosis may reduce treatment delay and thus lowering cardiac mortality and morbidity, and reducing hospital admissions, increasing the survival rate of patients within the accepted time-window. Telemedicine is a hot topic in the world recently; it changes conventional medical practice and enables patients to access medical service via telecommunication. The remote real-time electrocardiogram monitoring system is part of telemedicine, thus strengthens the self-management of high risk cardiovascular diseases group. However, Telemedicine in China began quite late and was known little about the sensitivity and accuracy on cardiovascular event.Objective: A remote electrocardiography monitoring system based on GPRS was tested in order to contrast the accuracy and stability of electrocardiosignal with the 12 leads ECG, then evaluated this device's clinical practice value, security and validity in the health subjects, the arrhythmia patients, the pacemaker patients and the myocardial infarction patients.Methods: 1. Total 30 health subjects were admitted to this research. Thirty subjects were received the portable remote real-time ECG monitoring and the 12 leads ECG. The remote monitoring collect electrocardiosignal to imitate V2,V3,V5 lead, I lead and avR lead. These electrocardiograms were printed during the monitoring and measured by an independent cardiovascular doctor to survey heart rate, the ECG time limit, and amplitude of vibration, baseline stability, and profile uniformity and so on. 2. In arrhythmia group, the data were collected from in-patient with from April 2008 to December 2008 in Fuwai hospital. All subjects were received the portable remote real-time ECG monitoring and the 12 leads ECG. These electrocardiograms were printed during the monitoring and measured by an independent cardiovascular doctor to survey heart rate, the ECG profile uniformity, and arrhythmic diagnose accordance rate.3. In pacemaker group, the data were collected from in-patient receied pacemaker from April 2008 to December 2008 in Fuwai hospital. All subjects were received the portable remote real-time ECG monitoring and the control instrument. These electrocardiograms which were printed during the monitoring measured by an independent cardiovascular doctor to survey heart rate, the ECG profile uniformity, and observe the pace function and sensation function, and evaluate the security of remote monitoring.4. In STEMI group, the data were collected from in-patient with STEMI from April 2008 to December 2008 in Fuwai hospital. All subjects were received the portable remote real-time ECG monitoring and the 12 leads ECG.. The remote monitoring device collects electrocardiosignal to imitate V1, V3, and V5 lead and I lead. These electrocardiograms which were printed during the monitoring and measured by an independent cardiovascular doctor to survey heart rate, the ECG profile uniformity, amplitude of vibration, ST segment change sensitivity and arrhythmic detection rate.Result: 1. In health subjects group, the electrocardiographic parameter of the two groups, such as the swing and time of has no statistical difference (P>0.05). The baseline stability of precordial leads is better than limb leads.2. The remote monitoring devices identify 266 cases of arrhythmia, including 135 cases of tachyarrhythmia and 131 cases of bradyarrhythmia. The arrhythmic diagnose accordance rate shows no difference. The electrocardiographic parameter of the two groups, has no statistical difference (P>0.05).3. In pacemaker group, the type of pacing include DDD pacing, VVI pacing, AAI pacing, ICD and CRT. The electrocardiographic parameter of the two groups, has no statistical difference (P>0.05). The pacing stimulation signal is clear, but the pacing impulse signal amplitude is lower than the control instrument. The remote monitoring device does not affect the pacing function.4. In STEMI group, the electrocardiographict of the two groups, has no statistical difference (P>0.05). The arrhythmic diagnose accordance rate show no difference (P>0.05). The ST segment elevate sensitivity also show no difference (P>0.05) in V1, V3, V5 lead and I lead. Elevate ST segment diagnose accordance rate how no difference (P>0.05).Conclusion: 1. The accuracy and stability of the portable remote real-time ECG monitoring system is in accordance with the standard ECG instrument.2. The portable remote real-time electrocardiogram monitoring system may be a helpful tool in assisting physicians in the diagnosis of common arrhythmia and malignant ventricular arrhythmia disorders.3. The remote monitoring device does not affect the pacing function, and show a security, reliability in follow-up visit.4. The sensitivity of the change of ST segment of the two groups is similar, and the remote monitoring device can help to the location of myocardial ischemia. This system could find the arrhythmia correctly.