It’s a busy office day, and Mrs. J is seated calmly in my exam room. She has a history of an intermittent heart rhythm disturbance. She says she feels well, but that she also gets a little dizzy at times and feels her heart skip once in a while. The nurse who took the vitals typed “pulse irregular” on the electronic chart. The last few times Mrs. J was in the office, the vitals were similar, and an ECG was usually obtained, showing only a minor abnormality.
I’d like to know if anything has changed, but it takes a couple of minutes to order the ECG, have the patient disrobe, attach 16 leads of the machine, and then record the rhythm –and I’m already a little behind.
Instead, I pull out my smartphone and ask Mrs. J to hold it gently in her hands for 15 seconds. Voila! On its display (and immediately uploaded wirelessly to a secured server) is Mrs. J’s heart rhythm, showing no significant change.
I am a tech nut and, some would say, an Apple “fan boy” (Okay, let’s get this straight, I am STILL using an iPhone 4, but for good reason. Keep reading to learn why!). I’m the one at the office who colleagues frequently come to for app advice. My latest app acquisition connects my personal interest to my professional work.
Typically, when talking all things Apple, I use the word “toy” frequently. This time, however, I can confidently say that my latest iPhone 4 case falls into the category of “tool.” And when I say tool, I mean an incredibly powerful device that is the first of many in the mobile realm that may significantly change health care.
The case looks like your generic thin, plastic smartphone case, with small holes for your camera, speakers, and charger. Yet, there are two metal plates on the back that set the case apart. These plates are the electrodes for a miniaturized ECG machine built into the case. It has its own power source, so that it doesn’t drain precious battery power from the iPhone, and works in conjunction with a free app that is downloaded from the App Store (The app was developed by AliveCor as a heart monitoring device). The case was approved by the FDA in December as a medical device, but only works with iPhone 4 and iPhone 4S (Sorry, iPhone 5 early adopters!).
Besides usage at the office, others have used it to diagnose heart attack at 35,000 feet in an airliner, or on a group bike ride to diagnose atrial fibrillation in another rider who was experiencing fatigue. One of the most amazing aspects of this case is how fast it wirelessly (via cellular or WiFi) uploads the ECG into the secured central server.
This case only available to health professionals now, but its low cost and ease of use make it ideal for patient use. Imagine a near future in which you receive a prescription for a smartphone case as a follow-up after your heart rhythm procedure? You are feeling a few skipped heartbeats while out on the soccer field watching your child’s game. You pull out your phone, open the app, and hold it steady for a few seconds. You then text your cardiologist to check your rhythm on the server. In a minute, your smartphone vibrates, and on the screen you see, “Everything is good!”
That’s a future this self-proclaimed “fan boy” is looking forward to.
Prospero B. Gogo, MD, is Director of the Cardiac Catheterization Laboratory at Fletcher Allen Health Care and Interventional Cardiologist. He is an Associate Professor at the University of Vermont College of Medicine.