Elevating cardiac outcomes through innovation and experience
Case Study
For patients with cardiac arrhythmia, which can cause palpitations, sudden loss of consciousness, and even death, inpatient cardiac monitoring allows doctors to observe their heart rhythms in real time and respond when a life-threatening arrhythmia is detected. For decades, cardiologists at Mayo Clinic have performed real-time cardiac monitoring on inpatients, using this data to guide treatment decisions. For patients outside the hospital, however, there has been no means to detect and respond to dangerous rhythms in real time.
A solution was needed to extend the quality of Mayo Clinic’s real-time monitoring program to patients beyond Mayo Clinic’s walls.
In situations where time is of the essence, most traditional remote cardiac monitoring platforms record arrhythmias to be reviewed at the completion of the study. Other models allow for patients to transmit data when they experience symptoms, or for data transmission when an arrhythmia is automatically detected. However, these scenarios fail to deliver real-time readings that offer complete and detailed pictures of a patient’s cardiac event. A faster, more sophisticated approach enables patients, who could be at risk for serious or even fatal cardiac events, to receive lifesaving treatment.
This approach has now been used in thousands of Mayo Clinic patients, including one patient for whom remote cardiac monitoring had a profound impact. The patient, a 29-year-old woman living in southern Minnesota, had been experiencing frequent spells while lying in bed. Her doctors assumed the events stemmed from a neurologic — rather than a cardiac — problem, and she had been diagnosed with a seizure disorder. She recalls waking from those events disoriented and afraid for her life. Because it was impossible to predict when the episodes might occur, her Mayo Clinic care team sought a method to capture her events in a way that would highlight the cause and get her the treatment she needed to put a stop to the terrifying episodes.
To more closely investigate the patient’s night-time episodes, her Mayo Clinic medical team recommended she undergo mobile cardiac telemetry. Mayo Clinic’s remote monitoring program uses InfoBionic’s MoMe Kardia system, an extension of the same near-real-time ambulatory cardiac monitoring provided to Mayo Clinic patients.
Designed and backed by Mayo Clinic’s cardiology practice, the program includes a three-lead, six channel platform designed for high-quality signal acquisition, complete data transparency, and ease of use. Rivaling the clarity of data found in inpatient settings, tracings provided through the platform are clear, comprehensive, and can be accessed in real time.
“A lot of institutions use patch-based devices, but you do not get the same quality electrocardiogram (EKG) through a patch, even though it might be more convenient,” says electrophysiologist Peter Noseworthy, M.D., medical director of MCCVS. “They offer poor quality leads and sometimes all you can tell is if the heartrate is fast or slow, so it’s very hard to tell what the underlying arrhythmia is. Even if a patient has an episode, and you’ve been able to record it, if the quality isn’t good enough, you’re no further ahead.
“We’ve taken the tactic that we’d rather do less monitoring but higher quality monitoring. And once we get a diagnosis, we are done because we have a gold standard test.”
less time spent monitoring patients
patients monitored
Not long after the patient began wearing the device, she experienced another nighttime episode. And, based on the quality of the lead tracings, it was crystal clear the patient did not have a seizure disorder.
“What she was having was serious cardiac arrhythmia episodes while she was sleeping,” Dr. Noseworthy says. “Because of how fast we received the full-disclosure reporting, we could act to get her treatment immediately.”
Because the patient’s local health care team had immediate and direct access to the full and complete monitoring data, they were able to search the tracings and identify the event based on the time it occurred. Quickly recognizing the severity of the event, the medical team was empowered to make a diagnosis in real time — as opposed to waiting for the final report — and ordered an air ambulance to take the patient to Mayo Clinic for care. Furthermore, the clarity of the multi-channel tracing was such that it not only illustrated the type of arrhythmia, but what was needed to fix it.
“The tracing was very clear. The precise cause of her arrhythmia was nicely demonstrated, and we could use the tracing to plan an ablation procedure,” Dr. Noseworthy says. “With other devices, we could often tell that the rate was too fast or too slow, but we lacked the resolution needed to direct a procedure.”
For the patient, remote cardiac monitoring did more than help her care team understand and treat her condition. “When it makes a diagnosis like this, it’s lifesaving.”
Visit cardiovascularservices.mayoclinic.com or fill out the form below to learn more about how to facilitate a Cardiac Monitoring engagement with Mayo Clinic.
