Approaching long term cardiac rhythm monitoring using advanced arm worn sensors and ECG recovery techniques.

Abstract

According to recent British Heart Foundation statistics, one in six men and more than one in tenwomen die from coronary heart disease (CHD) in the UK. This equates to almost 74,000 deaths perannum from CHD alone. More worryingly, every week, 12 apparently fit and healthy young peopleaged 35 and under, die from undiagnosed cardiac conditions. In both circumstances, monitoring ispreformed only when triggered by an event. Unfortunately, this may be too late in the large majorityof cases. For instance, there is evidence suggesting that most indiscernible cardiac abnormalitiesare made detectable by ECG through the act of suddenly standing upright. This infers that thecondition would be detectable during the course of everyday ambulatory activity and highlights theneed for a long term monitoring device. Current diagnostic equipment consists of the Holter monitor for extended periods up to 36 hours and the implantable loop recorder (ILR) for monitoring up to 3years. The diagnostic yield of the ECG monitoring strategy is greatly increased as the monitoringperiod increases. Therefore, for subjects that exhibit symptoms of cardiac involvement that aretransient in nature, the ILR offers the best opportunity for diagnosis. However, the ILR is insertedunder the surface of the skin in the upper chest area and requires a surgical procedure, withassociated risks, which makes ILR’s a costly and inconvenient option in many cases.The need for a non-invasive long term monitoring device, which is comfortable to wear along thearm and able to provide reliable ECG monitoring, has been addressed by many, in several lines ofapproach to a solution. This review details the current state of the art and any pending limitations. Itthen presents key multidisciplinary solutions on the different aspects of the problem, which will stillrequire integration in order to realise such a device