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Comment by spinchange | Hacker News Reader

I wonder all the time why we don't have more widely available, "consumer grade" tech like handheld ECGs, etc., to help better detect stuff like this. (There are products like this, but not in U.S. markets to my understanding - at least not without a prescription)

If you're unfortunate enough to suffer from something like anxiety attacks and also have heart trouble in your family's medical history it is very difficult (and expensive) to ascertain if you're having a panic attack or an actual cardiac episode.

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To properly rule out a heart attack you would need

a) A twelve-lead EKG - which requires twelve wires to be connected to specific locations on your body

and

b) Blood tests

Therefore for a consumer-grade device to properly rule out a heart attack it would need to be a large EKG machine with multiple connectors as well as a blood test analysis machine. And that's not even considering that proper analysis of an EKG trace requires a trained medical professional, as the automated traces are notoriously unreliable

Is that very different from a Holter monitor? Those are cumbersome, but seem like they could be a feasibly portable technology at some point. Also, those two tests are necessary for getting a relatively immediate result. Might a) alone provide valuable insights over a longer period of time? I could see your EKG over the course of 48 hours having the potential to provide a comparably accurate test result. Layman, obviously.

A Holter is essentially an EKG that's left on for a longer period of time. If a patient is coming in with chest pain and your want to evaluate for a heart attack, you really just need a single EKG (and ideally, an older EKG to compare to) to look for the characteristic EKG changes, and blood work to look for signs of damage to the heart muscle. It's really an instantaneous yes/no decision since if the answer is yes, you're likely going to the cath lab or the operating room within minutes (we're often judged on our "door to balloon time", meaning the time from the patient entering the ER to the time the stent is deployed in the heart)

There are other heart conditions that manifest intermittently for which a Holter can help diagnosis. There are a few companies out there working on innovative approaches to make the Holter less cumbersome -- I think iRhythm's ZIO patch was the first on the market and there's several more now. There also some interesting evidence that more subtle signs in the EKG or even unrecognizable-to-humans features of the electrical signal can help proactively predict heart attacks before they happen, but I think that's not yet validated or ready for clinical use. If those type of metrics/analyses prove useful, you could make a case for using Holter-type monitoring to identify a heart attack before it happens

Thanks for the response. Interesting stuff. Time will come when people look back and have trouble believing we lived without this stuff (like lacking antibiotics, knowledge of hygiene, etc.).

Once I learned I had Atrial Fibrillation (AF) I wrote an app that pulls my heart rate data from a normal consumer Polar chestband, then pushes it to a server where I can see it on Grafana.

It was incredibly useful, and helped me learn what the different feelings in my heart mean. I know exactly when I am in AF and when I am not.

There seems to be a huge gap for this kind of consumer grade offering, probably because the medical fraternity is extremely conservative about any technology, even though the alternative is ... nothing.

We are currently beta testing a device that can take your EKG and provide some level of analysis on your phone. If you are interested, we have currently have a private beta and have a few more openings! Of course we have much more planning in our production version. Please feel free to take a look: www.grektek.com. As the other reader mentions, cardiologists are the ultimate judges and even that can be difficult, but we have found helpful information can often be gleaned using our device and App.

Cool product -- especially like the idea of medication reminders in the watch. Is the silver thing on the face of the watch the second electrode for your EKG?

The "purchase" link goes to kickstarter which says the project is canceled?

Are you charging people for a beta test?

There are products like AliveCor's Kardia on the market. The issue is that it's difficult even for a physician to interpret EKGs, and automated interpretation has proven quite challenging. There's been a lot of progress in detecting certain rhythms like atrial fibrillation (which is what AliveCor's product is able to auto-detect), but other rhythm detection remains difficult.

Edit: Data science types wanting to tackle this problem, check out https://physionet.org/challenge/2017/

There are plenty of those available in the US. Check out https://www.alivecor.com/en/ for an example.

Awesome, thank you for the link. I don't know why I've not seen or found that yet!

That wouldn't be able to detect a heart attack, its to look for atrial fibrillation (AF), which is a long-term abnormality of heart rhythm associated with increased stroke risk

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