Title

Feasibility and Compliance with Daily Home ECG Monitoring of the QT Interval in Heart Transplant Recipients

Authors

Erik V. Carter, University of California, San Francisco School of Nursing, San Francisco
Kathleen T. Hickey, Columbia University School of Nursing, NYCFollow
David M. Pickham, University of California, San Francisco School of Nursing, San Francisco
Lynn V. Doering, University of California, Los Angeles School of Nursing, Los Angeles
Belinda Chen, University of California, Los Angeles School of Nursing, Los Angeles
Patricia Harris, University of California, San Francisco School of Nursing, San FranciscoFollow
Barbara J. Drew, University of California, San Francisco School of Nursing, San FranciscoFollow

Document Type

Article

Source

Heart & Lung

ISSN

0147-9563

Volume

41

Issue

4

First Page

368

Last Page

373

Publication Date

7-2012

Department

Nursing

Abstract

Background: Recent evidence suggests that acute allograft rejection after heart transplantation causes an increased QT interval on electrocardiogram (ECG). The aims of this pilot study were to (1) determine whether heart transplant recipients could achieve compliance in transmitting a 30-second ECG every day for 1 month using a simple ECG device and their home telephone, (2) evaluate the ease of device use and acceptability by transplant recipients, and (3) evaluate the quality of transmitted ECG tracings for QT-interval measurement.

Methods: A convenience sample of adult heart transplant recipients were recruited and trained to use the device (HeartOne, Aerotel Medical Systems, Holon, Israel). Lead II was used with electrodes that were easy to slip on and off (expandable metal wrist watch-type electrode for right wrist and C-shaped band electrode for left ankle). Patients used a toll-free number with automated voice prompts to guide their ECG transmission to the core laboratory for analysis.

Results: Thirty-one subjects (72% were male; mean age of 52 ± 17 years; 37% were nonwhite) achieved an ECG transmission compliance of 73.4% (daily) and 100% (weekly). When asked, how difficult do you think it was to record and transmit your ECG by phone, 90% of subjects replied “somewhat easy” or “extremely easy.” Of the total 644 ECGs that were transmitted by subjects, 569 (89%) were acceptable quality for QT-interval measurement. The mean QTc was 448 ± 44 ms (440 ± 41 ms for male subjects and 471 ± 45 ms for female subjects). Eleven subjects (35%) had an extremity tremor, and 19 subjects (55%) had ≥ 1+ left leg edema. Neither of these conditions interfered with ECG measurements.

Conclusion: Transplant recipients are compliant with recording and transmitting daily and weekly ECGs.

Rights

Copyright © 2012 Elsevier. All rights reserved.

PubMed ID

22459508

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.