Remote heart monitoring has been an effective part of heart treatment plans for more than two decades, and has continued to grow in importance during the COVID-19 pandemic.
The Food and Drug Administration, in the wake of the pandemic, expanded the use of certain non-invasive remote monitoring devices to facilitate patient management, including remote heart monitoring devices.
People with arrhythmia or an irregular heartbeat, who are under a doctor’s care, can help manage their heart condition from home via remote monitoring. There are several types of remote heart monitoring devices, including wearable devices and smartphones.
“In some cases, it’s now possible to do routine checks on both the heart and the device remotely without the need for a visit to the hospital or a clinic,” says Douglas Gibson, MD, director of cardiac electrophysiology at Scripps Clinic John R. Anderson V Medical Pavilion.
Your doctor can double-check any abnormal heart readings with a clinical or hospital-grade heart monitor.
“The doctor who receives the transmitted information can look for changes that have occurred either with the rhythm of the heart or device used.”
“In other cases, when the information sent indicates an emergency, the patient will be asked to go to the emergency room,” Dr. Gibson says.
An arrythmia is an abnormal heartbeat. It can be harmless or life-threatening. It may be brief, or last longer, causing the heart rate to be too slow or too fast, or causing the heart rhythm to be erratic.
There are different types of arrythmias. The most common is atrial fibrillation (AFib), where the upper heart chambers contract irregularly. AFib can lead to blood clots, stroke, heart failure and other heart-related complications. As many as 6.1 million Americans have AFib, according to the Centers for Disease Control and Prevention (CDC).
People at higher risk for AFib include:
- Older adults
- People with high blood pressure
- People with underlying heart disease
- People with a family history of AFib
- People with other chronic conditions, such as thyroid problems, diabetes and asthma
Symptoms related to arrythmias may include:
- Rapid heartbeat
- Shortness of breath
- Chest pain
In extreme cases, AFib can lead to sudden cardiac arrest.
Your doctor may order an electrocardiogram (ECG or EKG) to determine or diagnose an abnormal heart rhythm. Sensors or electrodes are attached to the chest and sometimes a limb to detect the electrical activity of a heartbeat. ECGs are often done in a doctor’s office, clinic or hospital, but can also be done from home.
If your symptoms are sporadic, a standard ECG may not capture the necessary information. Your doctor may recommend using a remote heart monitor, also known as ambulatory electrocardiographic monitors.
There are several different types of heart monitors:
A Holter monitor is a wearable device that records a continuous ECG, usually for 24 to 48 hours. Newer Holter monitors allow continuous monitoring for weeks.
A cardiac event monitor is similar to a Holter monitor, but is used for long-term monitoring of symptoms that occur infrequently.
Heart patients can wear these pager-sized devices for longer periods – typically 30 days – and use them to record heart activity as symptoms occur. In some devices, the ECG can be sent by telephone to the patient’s health care team.
“With the push of a button, an event monitor will record and store your heart’s electrical activity as symptoms occur. Your doctor analyzes and interprets the results and recommends treatment,” says Dr. Gibson.
There are different types of event monitors, including wearable and implanted devices.
A looping memory monitor stores your ECG for the period before and during your symptoms.
A heart monitor patch is an adhesive that is applied to the chest region.
The symptom event monitor is a hand-held or wearable device that is activated and placed in the chest during symptoms.
The implantable looping monitor is a pager-sized heart activity recorder that is placed under the skin of the chest for up to three years.
People can now use smartphones and smartwatches to capture and transmit ECG data to their health care providers.
In 2018, Apple introduced the Apple Watch Series 4, the first smartwatch that can monitor heart activity, detect an irregular heart rhythm and record the event. Cloud-based technology is used for virtual storage and secure sharing of medical information. Other wearable devices with an ECG feature have received FDA clearance since then.
When shopping for an ECG monitor for at-home use, look for one approved or reviewed by the FDA or another health organization.
Several devices have received FDA clearance to be used in conjunction with the Apple Watch and iPhone to detect several types of arrhythmias.
Make an appointment with your doctor if you think you have AFib or an irregular heartbeat and need treatment, and check if a heart monitoring device is right for you.