Appl Clin Inform 2011; 02(04): 481-498
DOI: 10.4338/ACI-2010-12-RA-0078
Research Article
Schattauer GmbH

Near Field Communication-based telemonitoring with integrated ECG recordings

J. Morak
1   Safety and Security Department, AIT Austrian Institute of Technology GmbH, Graz
,
H. Kumpusch
1   Safety and Security Department, AIT Austrian Institute of Technology GmbH, Graz
,
D. Hayn
1   Safety and Security Department, AIT Austrian Institute of Technology GmbH, Graz
,
M. Leitner
2   Department of Internal Medicine, Division of Cardiology, Medical University of Graz
,
D. Scherr
2   Department of Internal Medicine, Division of Cardiology, Medical University of Graz
,
F.M. Fruhwald
2   Department of Internal Medicine, Division of Cardiology, Medical University of Graz
,
G. Schreier
1   Safety and Security Department, AIT Austrian Institute of Technology GmbH, Graz
› Author Affiliations
Further Information

Correspondence to:

Jürgen Morak
Safety & Security Department
AIT Austrian Institute of Technology GmbH
Reininghausstraße 13/1
8020 Graz, Austria
Austria

Publication History

received: 03 January 2011

accepted: 11 October 2011

Publication Date:
16 December 2017 (online)

 

Summary

Objective: Telemonitoring of vital signs is an established option in treatment of patients with chronic heart failure (CHF). In order to allow for early detection of atrial fibrillation (AF) which is highly prevalent in the CHF population telemonitoring programs should include electrocardiogram (ECG) signals. It was therefore the aim to extend our current home monitoring system based on mobile phones and Near Field Communication technology (NFC) to enable patients acquiring their ECG signals autonomously in an easy-to-use way.

Methods: We prototypically developed a sensing device for the concurrent acquisition of blood pressure and ECG signals. The design of the device equipped with NFC technology and Bluetooth allowed for intuitive interaction with a mobile phone based patient terminal. This ECG monitoring system was evaluated in the course of a clinical pilot trial to assess the system’s technical feasibility, usability and patient’s adherence to twice daily usage.

Results: 21 patients (4f, 54 ± 14 years) suffering from CHF were included in the study and were asked to transmit two ECG recordings per day via the telemonitoring system autonomously over a monitoring period of seven days. One patient dropped out from the study. 211 data sets were transmitted over a cumulative monitoring period of 140 days (overall adherence rate 82.2%). 55% and 8% of the transmitted ECG signals were sufficient for ventricular and atrial rhythm assessment, respectively.

Conclusion: Although ECG signal quality has to be improved for better AF detection the developed communication design of joining Bluetooth and NFC technology in our telemonitoring system allows for ambulatory ECG acquisition with high adherence rates and system usability in heart failure patients.


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Conflict of Interest

None of the authors have any conflicts of interest associated with the work presented in this manuscript.

  • References

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  • 2 Hunt SA. American College of Cardiology; American Heart Association Task Force on Practice Guidelines.. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult. J Am Coll Cardiol 2006; 47 (07) 1503-1505.
  • 3 Scherr D, Zweiker R, Kollmann A, Kastner P, Schreier G, Fruhwald FM. Mobile phone-based surveillance of cardiac patients at home. J Telemed Telecare 2006; 12 (05) 255-261.
  • 4 Scherr D, Kastner P, Kollmann A, Hallas A, Auer J, Krappinger H. et al. Effect of home-based telemonitoring using mobile phone technology on the out-come of heart failure patients after an episode of acute de-compensation: randomized controlled trial. J Med Internet Res 2009; 11 (03) e34.
  • 5 Inglis SC, Clark RA, McAlister FA, Ball J, Lewinter C, Cullington D. et al. Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Cochrane Database Syst Rev 2010; 8: CD007228.
  • 6 Louis AA, Turner T, Gretton M, Baksh A, Cleland JGF. A systematic review of telemonitoring for the management of heart failure. Eur J Heart Fail 2003; 5 (05) 583-590.
  • 7 Chaudhry SI, Mattera JA, Curtis JP, Spertus JA, Herrin J, Lin Z. et al. Telemonitoring in patients with heart failure. N Engl J Med 2010; 363 (24) 2301-2309.
  • 8 Koehler F, Winkler S, Schieber M, Sechtem U, Stangl K, Böhm M. et al. Telemedical Interventional Monitoring in Heart Failure (TIM-HF), a randomized, controlled intervention trial investigating the impact of telemedicine on mortality in ambulatory patients with heart failure: study design. Eur J Heart Fail 2010; 12 (12) 1354-1362.
  • 9 Kastner P, Morak J, Modre R, Kollmann A, Ebner C, Fruhwald FM. et al. Innovative telemonitoring system for cardiology: from science to routine operation. Appl Clin Inf 2010; 1 (02) 165-176.
  • 10 Morak J, Kollmann A, Schreier G. Feasibility and usability of a home monitoring concept based on mobile phones and near field communication (NFC) technology. Stud Health Technol Inform 2007; 129 (Pt 1) 112-116.
  • 11 Madias JE. The resting electrocardiogram in the management of patients with congestive heart failure: established applications and new insights. Pacing Clin Electrophysiol 2007; 30 (01) 123-128.
  • 12 Jasemian Y, Arendt-Nielsen L. Evaluation of a realtime, remote monitoring telemedicine system using the Bluetooth protocol and a mobile phone network. J Telemed Telecare 2005; 11 (05) 256-260.
  • 13 Galbiati F, Takizawa K, Holopainen A. Mobile ECG - A new eHealth solution for telecardiology based on eHIT Health Gateway platform. Proceedings of the Med-e-Tel; 2007 April 1-3; Luxembourg. Luxembourg: Luxexpo; 2007. p. 101-4.
  • 14 Kailanto H, Hyvarinen E, Hyttinen J. Mobile ECG measurement and analysis system using mobile phone as the base station. Proceedings of 2nd International Conference on Pervasive Computing Technologies for Healthcare; 2008. Jan 30 - Feb 1; Tampere, Finland: p. 12-14.
  • 15 Laakko T, Leppanen J, Lahteenmaki J, and Nummiaho A. Multipurpose mobile platform for telemedicine applications. Proceedings of 2nd International Conference on Pervasive Computing Technologies for Healthcare; 2008. Jan 30 - Feb 1; Tampere, Finland: p. 245-248.
  • 16 Laugwitz B, Schrepp M, Held T. Konstruktion eines Fragebogens zur Messung der User Experience von Softwareprodukten. In Mensch & Computer 2006: Mensch und Computer im Strukturwandel. Munich, Germany. Munich: Oldenburg; 2006. p. 125-134. German.

Correspondence to:

Jürgen Morak
Safety & Security Department
AIT Austrian Institute of Technology GmbH
Reininghausstraße 13/1
8020 Graz, Austria
Austria

  • References

  • 1 Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJV, Ponikowski P, Poole-Wilson PA. et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008. Eur Heart J 2008; 29 (19) 2388-2442.
  • 2 Hunt SA. American College of Cardiology; American Heart Association Task Force on Practice Guidelines.. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult. J Am Coll Cardiol 2006; 47 (07) 1503-1505.
  • 3 Scherr D, Zweiker R, Kollmann A, Kastner P, Schreier G, Fruhwald FM. Mobile phone-based surveillance of cardiac patients at home. J Telemed Telecare 2006; 12 (05) 255-261.
  • 4 Scherr D, Kastner P, Kollmann A, Hallas A, Auer J, Krappinger H. et al. Effect of home-based telemonitoring using mobile phone technology on the out-come of heart failure patients after an episode of acute de-compensation: randomized controlled trial. J Med Internet Res 2009; 11 (03) e34.
  • 5 Inglis SC, Clark RA, McAlister FA, Ball J, Lewinter C, Cullington D. et al. Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Cochrane Database Syst Rev 2010; 8: CD007228.
  • 6 Louis AA, Turner T, Gretton M, Baksh A, Cleland JGF. A systematic review of telemonitoring for the management of heart failure. Eur J Heart Fail 2003; 5 (05) 583-590.
  • 7 Chaudhry SI, Mattera JA, Curtis JP, Spertus JA, Herrin J, Lin Z. et al. Telemonitoring in patients with heart failure. N Engl J Med 2010; 363 (24) 2301-2309.
  • 8 Koehler F, Winkler S, Schieber M, Sechtem U, Stangl K, Böhm M. et al. Telemedical Interventional Monitoring in Heart Failure (TIM-HF), a randomized, controlled intervention trial investigating the impact of telemedicine on mortality in ambulatory patients with heart failure: study design. Eur J Heart Fail 2010; 12 (12) 1354-1362.
  • 9 Kastner P, Morak J, Modre R, Kollmann A, Ebner C, Fruhwald FM. et al. Innovative telemonitoring system for cardiology: from science to routine operation. Appl Clin Inf 2010; 1 (02) 165-176.
  • 10 Morak J, Kollmann A, Schreier G. Feasibility and usability of a home monitoring concept based on mobile phones and near field communication (NFC) technology. Stud Health Technol Inform 2007; 129 (Pt 1) 112-116.
  • 11 Madias JE. The resting electrocardiogram in the management of patients with congestive heart failure: established applications and new insights. Pacing Clin Electrophysiol 2007; 30 (01) 123-128.
  • 12 Jasemian Y, Arendt-Nielsen L. Evaluation of a realtime, remote monitoring telemedicine system using the Bluetooth protocol and a mobile phone network. J Telemed Telecare 2005; 11 (05) 256-260.
  • 13 Galbiati F, Takizawa K, Holopainen A. Mobile ECG - A new eHealth solution for telecardiology based on eHIT Health Gateway platform. Proceedings of the Med-e-Tel; 2007 April 1-3; Luxembourg. Luxembourg: Luxexpo; 2007. p. 101-4.
  • 14 Kailanto H, Hyvarinen E, Hyttinen J. Mobile ECG measurement and analysis system using mobile phone as the base station. Proceedings of 2nd International Conference on Pervasive Computing Technologies for Healthcare; 2008. Jan 30 - Feb 1; Tampere, Finland: p. 12-14.
  • 15 Laakko T, Leppanen J, Lahteenmaki J, and Nummiaho A. Multipurpose mobile platform for telemedicine applications. Proceedings of 2nd International Conference on Pervasive Computing Technologies for Healthcare; 2008. Jan 30 - Feb 1; Tampere, Finland: p. 245-248.
  • 16 Laugwitz B, Schrepp M, Held T. Konstruktion eines Fragebogens zur Messung der User Experience von Softwareprodukten. In Mensch & Computer 2006: Mensch und Computer im Strukturwandel. Munich, Germany. Munich: Oldenburg; 2006. p. 125-134. German.