Remote ECG interpretation — guidelines and their implementation

Objective: e-Health is a relatively new medical trend, already finding place in clinical practice guidelines. Clinical cardiologists, however, are still not comfortable enough with interpreting, assessing and refining alarms and other information received remotely, in their practice. Prolonged ECG monitoring in stroke survivors enables the detection of episodes of silent atrial fibrillation (AF). Our aim in the present study is to prove the usefulness of e-Health implementation to detect silent AF in stroke survivors, as recommended in recent guidelines. Methods and results: We prospectively included 54 patients (mean age 54±15 years, 17% women) with cryptogenic stroke, without previously documented episodes of AF. We performed remote ECG monitoring for 22 days (range: 13–36 days). AF was detected in 14 patients (26%), mostly asymptomatic (64%) which prompted initiation of anticoagulation therapy. The mean time from initiation of telemonitoring to AF detection was 10 days (2–29 days). Conclusion: e-Health implementation via remote ECG monitoring, as recommended by recent ESC guidelines, is a very useful and easily applicable medical tool, enabling AF detection in at least one in every four stroke patients.