February 12, 2016

Size Matters--for Heart Monitors

The same technological advances that shrank telephones miniaturized heart monitors, with far-reaching implications for heart health.

By Eliene Augenbraun & David Sherman MD

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I am Dr. David Sherman. This is a special cardiology edition of Scientific American’s 60-Second Science. Got a minute?

Arrhythmias are sometimes hard to detect. If a patient comes into my office with an arrhythmia, I can make a diagnosis. But if he is not having an arrhythmia when he is hooked up to an EKG machine, I can’t tell what it is.

This problem goes back at least to the 1940s when this EKG machine was built for Dr. Howard Bruenn. Dr. Bruenn was FDR’s cardiologist, and he actually practiced in this office.

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Today’s EKG is basically the same as the old one, except today’s technology makes it a lot easier for the doctors and patients to use.

The technology to detect episodic arrhythmias is changing all the time. The key is to hook a patient up to an EKG-like machine for days, weeks or even months, until we catch the problem.

These monitors used to be large and heavy, attached to wires on the patient’s chest.

Patients didn’t like it, so they often didn’t want to use it.

Heart monitors got smaller and more convenient in the same way that telephones did.

They went from analog to digital, went wireless and slimmed their batteries.

As monitors got smaller and less intrusive, patients felt more comfortable using them, and we were able to get back more and more data.

This is a Holter monitor, a portable EKG machine that attaches to wires on the chest and monitors people for up to 48 hours.

This is a patch that’s put on someone’s chest, has no wires and it can monitor people for up to two weeks.

Now in some people, who have arrhythmias much less frequently, longer term monitoring was necessary. Implantable monitors were able to stay in for months to even years and diagnose things that were very infrequent. This is an earlier version of the implantable monitor. The newest ones are so much smaller that they can actually be injected right under the skin.

Better monitoring helps doctors make diagnoses, which then helps their patients make better decisions about what to do.

Thanks for the minute! For Scientific American, I’m Dr. David Sherman.

—David Sherman

[The above text is a transcript of this video.]

Credits:

Presenter: Dr. David Sherman

Writer/Director: Eliene Augenbraun

Producers/Videographers: Eliene Augenbraun, Benjamin Meyers, Lydia Chain

Special Thanks: Medtronics, iRhythm

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