KardiaMobile by AliveCor is a pocked-sized ECG capable of detecting atrial fibrillation (AF) – a leading cause of stroke in the UK.
The NICE-backed technology can be prescribed to NHS patients for at-home AF monitoring.
Sean Warren is UK&I Business Director at AliveCor. We sat down with him to find out more about how KardiaMobile could help identify the half a million undiagnosed cases in the UK.
Why is early detection of AF so important?
Stroke is the single largest cause of complex disability in the UK. And if you have AF, you are five times more likely to have one.
If we can detect more atrial fibrillation, more patients can be protected. The new novel anticoagulants in particular have huge success rate in reducing stroke risk.
How are people accessing KardiaMobile?
The NICE recommendation guidance states that physicians can prescribe the technology. We also support ICSs and CCG level facilities from a primary and secondary care perspective.
KardiaMobile can be procured directly from ourselves and we’re listed on the NHS supply chain catalogue.
But we’re also looking to empower patients to self-manage. You don’t have to get this via a medical institution, you can purchase KardiaMobile yourself via Amazon or Shopify.
Where is KardiaMobile already being used within the NHS?
In community care, doctors, nurses and cardiac physicians are visiting patients’ homes and taking ECGs. Patients are going to GP practices and GPs, nurses and healthcare assistants are taking their ECGs.
But the particular area where we have received the NICE recommendation is in an ambulatory setting.
When a patient comes in with some form of symptom, the device is prescribed to them for a longer period of time.
They can take multiple ECGs anytime, anywhere, and then share them directly with their physician to confirm if there was an abnormality or everything is okay.
What challenges does this help to overcome?
If you’re told by a physician that you may have a problem, the only way to capture and diagnose that problem is to have a symptom correlating ECG. So you must be symptomatic at that period of time and have an ECG.
That causes huge conflict, because for the stars to align for that to happen, it’s very difficult.
Especially if you have paroxysmal atrial fibrillation, which means you may be in AF once a month. But you may not be showing those symptoms straight away.
Sean Warren
A patient is told to get an ECG the next time they are symptomatic. But what are your options in that scenario?
You can go to your GP surgery, you can go to an emergency department, or you call an ambulance or paramedic to come to you.
Which may not be practical at the best of times…
Well, if it’s 2am, and you wake up in the middle of the night with palpitations, the GP surgery isn’t open, your emergency department is 45 minutes away.
And in Covid times, you’re discouraged to travel when you don’t need to. And if you do go to A&E, you could be waiting for four hours.
An ambulance might take an hour to arrive, if you’re lucky. But by now, you’re no longer symptomatic. So your ECG comes back your paramedic says you’re absolutely normal.
Is this a common problem?
Over 80 per cent of arrythmia patients will arrive at the hospital or have an ECG, no longer experiencing symptoms or abnormalities they were feeling earlier.
So if certain arrhythmias can become symptomatic for one to three minutes and then subside, so then then what happens, so you still have this worry, you still have this concern, and that there’s potentially no option.
People reference often AF as the ticking time bomb. You need to identify the AF quickly because you’re fighting the race against stroke.
If a patient with KardiaMobile wakes up having palpitations, they boot up their phone, take an ECG and within 30 seconds, they have a medical-grade reading.
This captures that abnormality which can then be shared with a physician who can use that diagnostic quality ECG to confirm that there was an abnormality and intervene if needed. This intervention could protect that patient from having a life-changing stroke.
So the patient is taking control
An ambition for us as a company is to empower self-management. Right now, physicians do not have the time because they’re under so much pressure.
Instead of getting the patient to come into the hospital, putting yourself at risk and other people at risk, these devices can in theory go out in the post, a patient can completely self-manage.
They are told, okay, when you have an abnormality, let us know.
Patients quite like that as well. That’s the feedback that we have, because the device is so easy to use. Patients are happy then that they’re there.
There’s no situation that a patient is diagnosing their own health, but they’re putting themselves in a situation where they can detect an abnormality.
It’s as easy as a traffic lighting system to then confirm with a physician.
How are you looking to adapt the technology in the future?
A 12-lead ECG is the standard of care for detecting and diagnosing abnormalities across the whole area.
So ideally, the situation would be that you’d have one in your pocket. We’re working on similar things like that in the future.
There are multiple QT-prolonging drugs which cause significant problems, such as antihistamines, antibiotics and hydroxychloroquine.
Also things like antipsychotics and antidepressants. These patients need to be monitored so that drugs can be titrated correctly.
We’ve been recognised by the European Society of Cardiology, the American Heart Association and the Mayo Clinic in the US and where our technology can be utilised to support those patient cohorts.
Anything else you would like to add?
We often hear that the first time a doctor learns about this technology is through a patient. And patients are new key opinion leaders.
What they’re doing and saying is so important because they have a life that we’re trying to change.
If we can educate the public to then educate physicians and vice versa, that can be very impactful.
We’re basically here to ask the question: Could a patchless, painless wireless technology offer a better solution?
