Pilot study: performance and acceptability of a portable ECG monitor in pregnant women with palpitations

Abstract

Palpitations in pregnancy are common. The majority of palpitations are caused by ectopic beats or an inappropriate sinus tachycardia, but a minority are caused by arrhythmias, the commonest of which is supraventricular tachycardia. The diagnosis relies on accurate detection of events by electrocardiography (ECG). It is critical to make an accurate and timely diagnosis as prompt intervention, or more commonly reassurance, can significantly impact the wellbeing of both mother and baby. The current standard of care is suboptimal for the identification of arrhythmias in pregnancy. Continuous ambulatory ECG recording can be performed for 1 to 7 days, but efficacy relies on episodes occurring during the monitoring period. The unpredictable nature of palpitations leads to a relative low diagnostic yield from intermittent monitoring. The longer the recording period, the longer a woman has to wait to have the monitor attached, due to limited availability of monitoring devices. The performance of this test, as well as the time required for analysis of the results, therefore may take several weeks. This is very significant given the limited duration of pregnancy and the importance of starting treatment in a timely fashion if an abnormality is present. There is therefore a role for a simple and reliable method for anytime ECG recording. The Kardia 6L is a simple method to obtain a six-lead electrocardiogram (ECG), using a small handheld device which communicates with the associated App on a compatible smartphone via Bluetooth, producing a real-time ECG recording. We hypothesize that Kardia 6L will expedite rhythm identification whilst being user-friendly and well-received by pregnant women reporting palpitations