When there’s suspicion of arrhythmia, nowadays you will be subject to a Holter investigation to make an accurate diagnosis. In order to catch your problem and register it, some people will undergo this cumbersome Holter investigation multiple times a year, without catching anything at all… All the while wearing this device makes that you can’t shower and are hindered in many daily activities, patients told us. Several wires and patches connect you with the Holter device to register the electric signals of the heart.
With the coming of emerging technologies onto the market, the department of Cardiology wondered, are there new ways to relieve the burden of undergoing a Holter investigation?
When interviewing different stakeholders in the current care process, we found out that the Holter device was used for many different cases. In fact, it was the one-stop-shop solution for diagnosing most arrhythmia problems, whereas cardiologists told us that for some types of problems not necessarily a full 12 leads ECG is needed to be able to pinpoint a direction for diagnosis. Also, not a full duration registration is needed to recognize the specific rhythm problem. We developed a matrix together with patients, cardiologists and analysts to map the needs for a specific group of patients with incidental rhythm problems. Next we scored many devices already available that are much more friendly to be handled by patients, but more importantly, are more apt for the task they are given.
For example, one of the solutions found was a patch for the back of a smartphone that records a single leads ECG while holding the device with two hands. Patients who feel something is going on take out their phone and start measuring. Being connected to the internet, a report of your ECG can be send instantaneously to the hospital to be analyzed. At this moment some of those patches are being tested by hospital staff and plans are made for using this solution next to conventional Holter investigations, to compare results and patient friendliness.
What did we do?
At the request of the Cardiology department, REshape interviewed patients and healthcare professionals. Also we developed a matrix together with patients, cardiologists and analysts to map the needs for a specific group of patients with incidental rhythm problems.
In the Netherlands there are 300.000 patients with suspicion of arrhythmia. Some of them will be diagnosed using a Holter device. (source: www.hartstichting.nl)
“It was interesting to find that for many types of problems the Holter device was used, while much more patient-friendly options exist that might also be more suitable for specific groups of patients.”
Lonneke van Reeuwijkmanager of the Cardiology department
“All needs and barriers of patients and cardiologists are taken into account, for example: are we sure when we feel something? Are we not too late with measuring so that we might miss important registrations? Patients and cardiologists moved together as partners in this project. This has lead to a new way of registration of arrhythmia, that soon starts in the Radboudumc.”