Screening For Cardiac Dysrhythmias in Rural India Using a Smart Phone ECG Application (2014)

Undergraduate: Nikhil Patel

Faculty Advisor: Anil Gehi
Department: Economics

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Introduction- Cardiovascular disease is the leading cause of death in India. Accessibility to healthcare is particularly limited in rural India. Telemedicine utilizing a smartphone application may be a useful screening tool in rural areas.

Methods- Patients seeking medical care at several rural villages outside of Pune, India were screened for dysrhythmia using a smart phone application (AliveCor, San Francisco, CA). A single-lead ECG was transmitted remotely to an expert cardiologist (University of North Carolina) and assessed within 24 hours. For any ECG abnormality identified, the patient was contacted and provided with a referral to receive follow-up care.

Results- During one month (July, 2013), 221 patients were screened. The mean (SD) age of the cohort was 35.0 (14.4) years and 71.8% were male. Comorbidities included hypertension (4.5%), diabetes (10.9%), and smoking (36.4%). On cardiac review of symptoms, 14.5% of patients had chest pain, 2.3% lightheadedness, 2.7% syncope, 5.9% palpitations and 8.2% dizziness. Of the 221 patients, 219 (99%) had ECGs taken with a clearly interpretable rhythm (Figure). Of the 219 patients, 4 were recommended for follow-up care. One of these 4 had atrial flutter and the other 3 had sinus tachycardia.

Conclusion- AliveCor provides a high quality single-lead ECG that can be rapidly transmitted and interpreted. A smartphone ECG is feasible as a screening device to provide early identification of potential cardiac illness.