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Comparison of a smartphone-based ECG recording system with a standard cardiac event monitor in the investigation of palpitations in children
  1. Mairi Macinnes,
  2. Nicholas Martin,
  3. Helen Fulton,
  4. Karen A McLeod
  1. Royal Hospital for Children, Glasgow, UK
  1. Correspondence to Dr Karen A McLeod, Department of Cardiology, Royal Hospital for Children, Glasgow G51 4TF, UK; karen.mcleod{at}


Background The AliveCor (Kardia) monitor attaches to a smartphone and allows a single-lead ECG to be recorded during symptoms. In 2016, we introduced the use of this smartphone device for investigating palpitations, without syncope, in children. The aim of our study was to review our experience with the smartphone device, comparing it with our previous standard conventional approach to cardiac event monitoring using the Cardiocall monitor, which uses skin electrodes and is given for a finite period.

Methods Over a period of 24 months, 80 smartphone monitors were issued and compared with the most recent 100 conventional event monitors. The number of ECG recordings received, arrhythmias documented, quality of ECG recordings and patient satisfaction were evaluated.

Results Median patient age was 11 years in the smartphone monitor group compared with 10 years in the conventional group. Seventy-nine of 80 (98%) patients with a smartphone monitor sent an ECG recorded during symptoms, compared with 62/100 (62%) from the conventional group. A total of 836 ECG recordings were sent from the smartphone monitors compared with 752 from the conventional group. Eight per cent of ECG recordings in each group were of inadequate quality for analysis. Twenty of 80 (25%) patients with a smartphone monitor had documented tachyarrhythmia compared with 6/100 (6%) patients with the conventional monitor (p<0.001). On comparison with the conventional approach, the smartphone monitor outperformed with respect to diagnostic yield and patient satisfaction.

Conclusions A smartphone-based event monitor allows simple, effective, long-term ECG event monitoring in children that is highly acceptable to the patient and parent.

  • cardiology
  • monitoring
  • paediatric practice

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  • Contributors MM was involved in data collection, creating the patient satisfaction questionnaires, analysing the data and was the main author in writing the paper. NM and HF did most of the data collection and analysis. KAM had the idea of reviewing our institution’s experience of issuing a smartphone cardiac even to investigate children with palpitations. KAM was involved in data analysis and had a major contribution to writing the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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