Picture of Dr. Frank-Chris Schoebel
Dr. Frank-Chris Schoebel
Dr. Frank-Chris Schoebel arbeitet seit 25 Jahren als Kardiologe in Düsseldorf und war über 16 Jahre Mitarbeiter in der Klinik für Kardiologie, Pneumologie und Angiologie am Universitätsklinikum Düsseldorf, davon 6 Jahre als Oberarzt. Zum Profil.

FOR WHOM is the Smartphone 1-channel ECG useful?



Heart stumbling, tachycardia – only an ECG can confirm a diagnosis

The symptoms of cardiac arrhythmias vary. They tell us „my heart stumbles again and again“, „my heart races“, „sometimes I have the feeling my heart makes a pause“, „between through my heart is so slow“ or „lately my heart beats completely irregularly every now and then“.

Symptoms may indicate specific rhythm disturbances, but only the ECG allows an exact diagnosis and thus a reliable risk assessment. Many rhythm disturbances are harmless, but some can have serious health consequences.

An important question that we are asked again and again in Cardiopraxis is:

  • Should I even measure a smartphone ECG?
  • How should I derive a Smartphone ECG?
  • When should I determine a 1-channel ECG?

Why measure 1-channel ECG?

The Smartphone ECG is particularly useful if you have symptomatic rhythm disturbances that have not yet been registered in writing. The measurement with written documentation is particularly important for the physician, because only then a correct diagnosis becomes possible and thus also the correct therapy. Rhythm disturbances are often rare, e.g. once a month.

Smartphone ECG – who should use this feature?

We know 3 large groups of people who can benefit from a 1-channel ECG. I’ll take these:

  • Symptoms of cardiac arrhythmia
  • an increased Risk for atrial fibrillation
  • known cardiac arrhythmias

People with symptoms and unknown cardiac arrhythmias

Symptoms of cardiac arrhythmia can manifest themselves in many different ways. Sometimes you just notice a sudden feeling of discomfort, restlessness on your chest or a shortness of breath. Something more specific for cardiac arrhythmias are:

  • palpitations
  • slow heartbeat
  • heart stumble
  • irregular heartbeat

In the case of occasional symptoms, a rhythm disorder is often not yet documented in writing. It is precisely here that recording with a smartphone makes sense in order to make a correct diagnosis.

People with symptomatic rhythm disturbances measure at the time of the symptoms, quasi at the „point-of-action“. Furthermore, symptomatic people should also measure occasionally, i.e. 1-2 times per week, independently of the symptoms, in order to detect and document asymptomatic rhythm disturbances if necessary.

Risk patients for atrial fibrillation

From our point of view, it makes sense for people with an increased risk of atrial fibrillation to regularly drain a single channel regardless of the symptoms. The risk group includes people:

  • Age >65 years
  • high blood pressure
  • diabetes mellitus
  • enlarged ventricles in the heart ultrasound
  • relevant heart valve disease
  • cardiac insufficiency
  • circulatory disturbance of the heart (coronary heart disease, after myocardial infarction)

If you have an increased risk for atrial fibrillation, then you should measure e.g. 2 times per week independently of symptoms. Thus asymptomatic episodes of atrial fibrillation can be detected.

style=“font-size:14pt;“>People with Known Cardiac Arrhythmias

It makes sense to measure twice a week if you have rhythm disturbances known and documented. Initially harmless rhythm disturbances, such as increased atrial extrasystoles, are often the harbinger of atrial fibrillation.

How should a 1-channel ECG be measured with a smartphone ECG?

If you want to derive a high-quality 1-channel ECG with your smartphone, then a good measuring routine is important. This is the only way to derive a usable ECG without disturbances, so-called artefacts.

The movement of the arm often plays a significant role and results in artefacts. This is similar to a blurred photo, we often cannot recognize the findings correctly. It is best to conduct a smartphone ECG while sitting down and place your arm on the table. Do not speak during recording. You should save the ECG and possibly print it out for a closer look.

You should be prepared for the situation, as some rhythm disturbances only last a few minutes. Therefore it makes sense to practice the handling of the respective system. In addition, it is very valuable to measure repeatedly in the case of a conspicuous measurement and thus to document how long the cardiac arrhythmia lasts.

Smartphone ECG – automatic diagnosis of atrial fibrillation – best communication with a cardiologist

Cardiologists are specialists in cardiac arrhythmias and have been trained for a long time. You should therefore discuss the procedure for transmitting and evaluating the findings with a cardiologist.

The diagnostic function on the AliveCor or Apple cardia devices has the following features with regard to Atrial fibrillation over three diagnoses:

  • normal
  • unclassified
  • possible atrial fibrillation

For the diagnoses „unclassified“ and „possible atrial fibrillation“ we recommend contacting us promptly. Atrial fibrillation increases the risk of stroke. In Cardiopraxis, many people whom we care for have our e-mail or mobile phone number so that the transmission can take place quickly, even via text messaging.

In the event of symptoms such as breathlessness or dizziness, we advise you to go to an emergency reception centre or call the emergency services at 112.

Cardiopraxis – Cardiologists in Düsseldorf & Meerbusch

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