National Heart Centre, Mistri Wing, 17 Third Hospital Avenue, Singapore 168752.
Singapore Med J. 2010 Jul;51(7):565-9.
Arrhythmias are often intermittent, and a normal electrocardiogram (ECG) may not be diagnostic. The purpose of this study was to evaluate the usefulness of HeartWave500 (HW), a novel web-based ambulatory ECG monitoring device.
A total of 120 patients from the National Heart Centre, Singapore were prospectively randomised in a three to one ratio to either HW or a standard transtelephonic (TT) event recorder. HW records five leads and transmits to an internet server, while TT transmits audio data to a central station. Monitoring was conducted for two weeks. The diagnostic yield was calculated in two ways: the percentage of patients successfully diagnosed as a function of time, and the absolute number of new diagnoses per patient per week.
33 patients (14 male, 19 female; mean age 49.6 + or - 11.1 years) were randomised to TT. 87 patients (32 male, 55 female; mean age 43.7 + or - 12.2 years) were randomised to HW. At the end of two weeks, the percentage of patients diagnosed with any arrhythmia was similar for both groups (66.7 percent for TT versus 67.8 percent for HW). There was a trend toward significance for the number of diagnoses per patient per week for Week 2 between TT and HW (0.58 + or - 0.75 versus 0.34 + or - 0.55, p is 0.06). Transmitted ECGs were read earlier for HW (18 minutes versus 1107 minutes, Mann-Whitney non-parametric test, p is less than 0.05). Transmitted recordings that were unreadable were also significantly lower for HW (8.0 percent versus 17.6 percent, chi-square test, p is less than 0.05).
HW and TT have similar diagnostic yields. There is a trend toward a shorter monitoring time for HW. The ability of HW to record and transmit via the web, the earlier review of data and low unreadable data make HW an attractive alternative to TT.
心律失常通常是间歇性的，正常心电图（ECG）可能无法诊断。本研究旨在评估 HeartWave500（HW）的实用性，这是一种新型基于网络的动态心电图监测设备。
新加坡国家心脏中心的 120 名患者前瞻性随机分为三组，每组 1：3 比例分配到 HW 或标准远程（TT）事件记录器组。HW 记录 5 个导联并传输到互联网服务器，而 TT 则将音频数据传输到中央站。监测时间为两周。诊断产量以两种方式计算：作为时间函数成功诊断的患者百分比，以及每位患者每周的新诊断绝对数量。
33 名患者（14 名男性，19 名女性；平均年龄 49.6±11.1 岁）被随机分配到 TT 组。87 名患者（32 名男性，55 名女性；平均年龄 43.7±12.2 岁）被随机分配到 HW 组。在两周结束时，两组患者被诊断出任何心律失常的百分比相似（TT 组为 66.7%，HW 组为 67.8%）。TT 和 HW 组在第 2 周的每位患者每周诊断数量上有显著趋势（0.58±0.75 与 0.34±0.55，Mann-Whitney 非参数检验，p 值为 0.06）。HW 更早地读取传输的 ECG（18 分钟与 1107 分钟，Mann-Whitney 非参数检验，p 值小于 0.05）。HW 的不可读传输记录也明显较低（8.0%与 17.6%，卡方检验，p 值小于 0.05）。
HW 和 TT 的诊断产量相似。HW 的监测时间有缩短趋势。HW 能够通过网络记录和传输、更早地查看数据以及低不可读数据，使其成为 TT 的一种有吸引力的替代方案。
