Comparison of handheld,
1-lead/channel ECG / EKG recorders

 

by James W Grier
Department of Biological Sciences
North Dakota State University
Fargo, North Dakota, USA

 

Latest revision: ... 22 March 2014

(website currently undergoing major revisions and updating)

Previous revisions: 2006-2008, 2013, 2014 (Feb, March...)
Original version: 2006

 

Photos of the eleven handheld ECG devices reported in this website. The first photo is of the original three devices (in the original order) that were reviewed in 2006-2008 and which are still current, except for revisions of devices and software and the PC-80 may soon be discontinued in favor of the considerably revised and essentially different device, the PC-80-B Color (shown in the second photo). The top row of the first photo is of the devices closed, bottom row of them open (RMH and IC are compact style, with lids). The latest eight additions to this webpage are pictured in the second photo in more-or-less alphabetical order (but also keeping similar styles together). The two photos have been sized to illustrate all devices to approximately the same scale.

 

handheld_ECG_first-3-devices.jpg (46471 bytes)

 

handheld_ECG_second-8-devices.jpg (151644 bytes)

 

[A summary table of all of the devices together, involving the main features and uses of each device, may also be added later, after completion of the rest of the website's reorganization and reconstruction.]

 

CONTENTS [not yet linked internally, you will have to scroll down to the various sections; some of the sections also have several subsections; internal links are being prepared]

bd14583_.gif (175 bytes)  Disclaimers/warnings/cautions
bd14583_.gif (175 bytes)  Introduction and Background
bd14583_.gif (175 bytes)  General comments about the devices reviewed
bd14583_.gif (175 bytes)  Devices tested: descriptions, with photos and ECG outputs/reports
*** section under major construction -- stay tuned ***

        AliveCor
        Dimetek Micro Ambulatory ECG Recorder, DiCare-m1CP
        ECG Check
        HeartCheck Pen
        InstantCheck
        MD100E
        PC-80
        PC-80B Color
        (printing) ECG/EKG-80A (...-90A?)
        ReadMyHeart
        REKA E100
bd14583_.gif (175 bytes)  About the Author
bd14583_.gif (175 bytes)  Appendix: Disclosure/transparency re. potential conflicts of interests

 


Important DISCLAIMERS/WARNINGS/CAUTIONS and information, PLEASE READ THIS FIRST:

Warning/caution --

This website is provided for informational, educational purposes only, NOT medical advice.

In the event of heart problems or even the possibility of heart problems, contact your physician. Do not attempt to self-diagnose or spend time with self-help resources, including personal ECG devices, when urgent or emergency situations may be occurring..

In the event of an emergency or suspected-emergency situation, appropriate medical help and facilities should be sought as quickly as possible. The only time that personal ECG recorders should be even considered in urgent, emergency situations, except as prescribed by a physician or when used by emergency personnel, would be if problems were to occur in remote locations to obtain useful information and/or while waiting for transportation and help, that is, when the use of the recorders would not delay possible help and might permit the collection of useful information for later use.

Intended audience --

This information is intended for the general public, physicians, medical centers, and other health-care providers such as EMT personnel and nurses, instructors and students (pre-med, other health-related, general), electrical and biomed engineers and designers, and manufacturers and distributors. In addition, this information and the comparisons may be of interest to investors because the industry is expected to grow rapidly (and be highly competitive) in the next few years. In short, this webpage has been prepared for anyone who might have an interest in handheld ECG devices. Most, but not all, of these are currently 1-lead/channel, but I have included one 12-channel device (the printing one, ECG/EKG-80A), some of the others can be used to obtain good (sequential) 12-lead recordings, and I anticipate new, handheld, 12-lead (even simultaneous) ECG devices coming on the horizon.

As indicated in the warning section above, the information in this website is provided for informational/educational purposes only. For medical and health-care providers, see the next paragraph. For untrained persons, the devices are potentially useful for exercise- or sports-associated (by healthy persons), research, educational, and non-emergency monitoring use only, not diagnostic or emergency uses.

For health-care professionals, however, the information here may be useful for evaluation and consideration of potential 1-lead/channel products (similar to familiar cardiac event and Holter recorders) for monitoring of and by patients including post-surgery, monitoring for arrhythmias such as afib, PVCs, PACs, ventricular tachycardia or bradycardia, and related monitoring and recording.

A rapidly-changing and highly-competitive field --

At least for the foreseeable future, this website is expected to undergo frequent revision and be subjected to further reconstruction. Technology is rapidly changing; products and software are being revised; new products are proliferating; and pending my available time and with accumulated experience, testing of recorders, exposure to new products and software, and input from other persons, I may add, delete, and revise sections as well as reorganize this site. It is also an expanding webpage and continuing to grow. Until internal links are added, you can simply scroll past sections that you aren't interested in to find sections and information that you might want. Thank you for your patience with the site's current condition. Check back later for updates, possibly additional ECG recorders, and other revisions.

Criteria for inclusion of ECG devices on this webpage --

ALL of the ECG devices described and covered in this review are ones that I consider acceptable for their respective uses. They each fill a slightly different niche, as described with the various devices. It is completely up to the potential users to make informed decisions about which is best for their particular needs. It's like buying a vehicle: there are several brands and models available. Different persons are interested in different ones for different reasons.

The only ECG devices listed here are those that I’ve had sufficient time to evaluate and which I considered worth listing. There are many more available in the market. There have been a number of new handheld ECG systems and various revisions that I tested but which weren't very good in my opinion or worth updating this website for. Thus, I have not included them here. Others I am still testing, including in some cases working with the designers/manufacturers to improve. There are several others that I simply have not had the time, inclination, or other resources to test. There are more out there, and more appearing every day, than I am able to test and report on, sorry (both to the companies and the readers).

My principle is “If you like what you see, tell others. If not, tell me”. Thus, I will publicly describe products that I have tried and which sufficiently meet my personal criteria. I also will gladly (pending my time and availability) test and help designers and manufacturers improve their products by reporting my detailed test results and problems that I encounter back to them for their in-house, proprietary purposes and revisions (and I treat those proprietary interactions with each company or distributor on a non-disclosure basis, whether formal or implicit). I have done that with several companies and the public results shown here generally reflect their latest, revised versions and models. In my opinion, that is advantageous to everyone: users and public health-care, physicians, and the industry as a whole. (The principle, incidentally, works both ways. If you like this webpage, tell others. If you have problems with it or want to provide various input, please send your comments, corrections, and compaints to me so I can revise the webpage.)

I do not, however, endorse any given product. Like “Consumer Reports”, I do not want my statements to be used by anyone for advertising purposes. The exception is that anyone, including distributors and manufacturers, may freely link to or reference this website as long as they do not expand on it or use my specific statements as an endorsement for their product. I maintain my right to objectivity, academic and professional integrity and freedom, lack of influence and bias from vested interests, and my right to work with any and various companies and distributors. I have tried to emphasize the facts and minimize personal opinions beyond what I consider to be my acceptable criteria. Some of the features of some of the devices are truly impressive, however, and I maintain my right to express personal opinions on those points.

Sections About the Author and Disclosure/transparency regarding potential conflicts of interest are included at the end of this website.

 


Introduction and Background

ECG/EKG basics --

Electrocardiograph (ECG or EKG -- the two are synonymous, just different spelling) machines/recorders are no longer just the large, bulky equipment that they once were. Even some of the full 12-lead recorders today are small, portable, and operate through desktop and laptop computers or other devices.

Now there are even smaller, self-contained, simple, one lead (or "channel") recorders that are handheld, pocket-sized, battery operated, and have their own built-in displays. These new, low-priced, 1-lead handheld ECG recorders have become available for physicians to prescribe for patients and some over-the-counter (OTC) for personal, home, and exercise or sports use, much as with home blood-pressure/pulse recorders or glucose testers for diabetics (but see below for qualifications and complications).

Note that this technology and availability of personal ECG recorders are new and just now entering the consciousness of mainstream health care. Many physicians and cardiologists themselves are not yet familiar with these devices!

They are potentially suitable in some emergency situations but only by order of a physician and when used by medical or emergency personnel or for obtaining useful information while waiting for emergency help to arrive. Otherwise, they can be used by the general public (generally in consultation with and approval by a physician) for non-emergency personal recording of information, such as for baseline information, routine monitoring, or during uncommon cardiac events. The recordings can then be shown to the person's cardiologist or electrophysiologist or, for non-emergency or simple monitoring purposes, used by the person himself or herself if he or she is able to interpret them. (ECGs and their different "leads" are complex and have a fairly steep learning curve. For a basic introduction, click here.)

ECG machines record the faint electrical signals produced by the heart and which spread throughout the body all the way to the skin. The ECG machine or device picks up the signals by contact with the skin through interfaces called electrodes (the name of the contact surface). The process is non-invasive, harmless, and risk-free. ECG machines are carefully designed to separate any electricity used to power the machine from the heart signal detection and recording process so the machine is unable to accidentally shock the persons involved, thus, insuring their safety.

The resulting records of the heart signals, the wavy lines called ECG waveforms or patterns, are generally familiar to everyone. The pattern is seen on monitors in hospitals and clinics, stylized on the sides of ambulances and in advertising, seen on TV and in movies, etc.

The "devil is in the details" --

The actual details of the pattern, however, are very complex and require a trained and experienced human eye, normally of a licensed physician or certified ECG technologist, to interpret, understand and diagnose the recorded ECG and then a licensed physician to recommend or prescribe medications and courses of action, including possible reference to further medical specialists.

Unlike many other health and physical characteristics, such as blood pressure, simple pulse rate, or blood glucose levels, ECGs do not have just one or a few numbers to work with. Even the heart rate may include irregularities and changes in the rhythm and shape (morphology) of the ECG waves. ECGs involve subtle aspects, characteristics that are relatively unique to each individual person (somewhat like fingerprints), complicated combinations of characteristics, and often, on their own, don't give a complete picture of what the heart is doing. ECGs provide very good measures of the heart’s condition but an ECG is only one set of measures. Additional tests may be needed for an accurate diagnosis of a person’s heart.

Automated measurements and interpretations of ECG patterns by the ECG machines or computers (including by the best available) notoriously make mistakes including both false positives (identifying conditions that are not actually present) and false negatives (not detecting conditions which are present).

... and things get tricky!

As a result of the difficulties described above, particularly when there may be medical conditions or issues (and potentially legal issues), a real, live physician must be involved at some point. Accordingly, ECG machines are classified as medical devices and, in the US, the government regulating agency, the FDA, requires clearance or approval (not the same, but I'm not going into that) of them before they can be sold in the US. The FDA also requires that the machine and associated materials be properly labeled with appropriate warning and caution statements, and, unless cleared for over the counter (OTC) restricts their sale to physicians or on the order of a physician. The regulations have not been strictly enforced at the level of actual sales and purchases, but manufacturers and distributors of ECG machines must pay close attention, get FDA approval for new products, and use proper labeling. All of this helps protect the public, physicians, and industry, including the industry from legal liability. At the same time, regulations are having difficulty keeping up with the rapidly changing technology and global marketplace. A number of grey areas, potential risks, and questions are arising such as just what is the role of the physician and related FDA matters (example, including be sure to scroll down to the subsequent comments section which contains much discussion on numerous issues).

... but there is hope!

Although the heart conditions people can have and their associated ECG patterns cover a vast range of possibilities, in any given person, if not normal, there is usually has just one or at most a few conditions present. A physician can teach the person what their ECG pattern(s) look like and what to watch for. Thus, while persons who are not physicians should not try to diagnose their own or others' ECGs, they can nonetheless learn what to watch for and monitor themselves for changes that are specific to their cardiac health status. This, along with rapid advances in technology and a recent general increase in the public's interest and participation in management of their own health care, has led to the introduction of low cost, relatively simple and small, handheld, portable ECG devices. There are now many readily available and more on the horizon. This website discusses some of them.

Who cares about ECGs, how much, and why?

Just as different ECG machines vary, so do the needs and interests of different persons. Most healthy persons have little interest in ECGs, theirs or anyone else’s. Most normal heartbeats are the same, beat after beat, for millions of beats. Although they might vary slightly for an individual and from person to person, "when you've seen one you've seen 'em all".

But, with the heart as central and critical to life as it is, if something goes wrong or there is even a hint that something might be wrong, most people begin to take notice and may become interested in what’s going on! However, the majority of persons still aren't interested or able to deal with the detailed intricacy of ECG interpretation; they want their physician to handle all of the details. Thus, they or their physician may want a personal monitor for the patient that the patient can operate but everything is then handled by the physician and they simply communicate (via modern technology) with each other.

At the other extreme, there are persons who, while still being involved with a physician with their heart conditions via normal, typical health care hospital and clinical routes, also want to monitor their conditions themselves. In addition, there are many persons with normal healthy hearts, including athletes, persons who are active and do serious workouts or exercising, pre-med and other health-care students, instructors, or others interested in cardiovascular topics, and people who travel to remote areas who want to have equipment for educational purposes or monitor their hearts on their own, pretty much independently, like weighing themselves or monitoring their own blood pressure and heart rate.

In between the two extremes, there are many people who want to maintain very close association with and supervision by their physicians but who want to do their own recording and then take the results to their doctors. The variety of ECG devices now available covers the whole range! I have attempted to show where each of the devices that I reviewed fits into the picture.

Note: more devices available than just handheld ECG devices ...

There are also a number of other ECG-like devices, heart monitors, and pulse oximeters including wrist and wrist-chest devices, that only show heart rate or pulse rate (pulse rate is not always the same as heart rate because some irregular heart beats produce electrical signals but do not register on the pulse). Some of these devices produce long-term records, storage, and computer or cloud-based options for viewing and analyzing results. I am not sure how they might compare with the handheld ECG devices on this webpage for identifying such things as irregular heart patterns, such as afib. I have not tested them for comparison and am not including them here.

 


General comments about the devices reviewed


Categories or types of devices: prescription versus over the counter, server- or "cloud-based" versus stand-alone

Some of the handheld ECG devices and their software or apps are  physician- or central-server/analysis-, "cloud"-based ECG systems in which the users interact with their health care providers by using small, portable, ECG recorders designed specifically for working over the internet and/or smart phones, in most cases via various apps. Their data are sent to a physician or central site for analysis, with results reported back to the patient or user. There may be per-use charges for some of these devices.

These may prove to be a great choice for both the majority of patients/users and physicians, as alternatives to previous, old-style "event recorders" and even some Holter applications.

However, a few users want to view the results on their own computers and under their own control, even if they also pass the results on to their physicians, and who may not like the need to go through the "cloud". Thus, there are also completely stand-alone, non-cloud choices.

Some of the ECG recorders are available for over-the-counter (OTC) purchase, and anyone can get one, use it themselves (including with the associated interpretation services that are also available from some companies when desired or needed), and/or communicate the results with their physicians. Although some of the devices are OTC and show basic results of recordings, such as heart rate and a simple statement or icon regarding the outcome, they still require initial contact with a physician, either via a provided interpretation service or the user's own doctor, before the full functionality of the device is enabled. I anticipate that some of these OTC ECG devices will begin appearing in pharmacies and chain stores.

The ones (of all types) that I have tested are shown below with brief descriptions and links. I plan to eventually provide expanded descriptions, photos, results of my testing, and more details here. In the meantime, most have lots of descriptive information available in their various links.

Dry metal, finger/thumb/skin contacts versus adhesive skin electrodes and cable/lead-wire connections

Most of the handheld devices have simple metal contacts that the user can place their thumbs or other fingers on or place against bare skin, such as on the chest. The metal contacts are much more convenient and faster to use than adhesive (or older, electrode cream style) skin electrodes. Some of the devices, not all, also can be used with optional adhesive skin electrodes (usually of the "snap" variety) and cable/lead-wire connections. Some use three lead wires (negative, positive, and ground/neutral) whereas some use just two (negative, positive). (The negative electrode is normally used with the right hand or side of the body and the positive on the left. They usually are just labeled "L" and "R". Colors vary among the different devices and their color schemes).

Examples of the metal skin contacts versus lead wires are shown in the figure below (from the original three devices reviewed on this website, 2006-2008). All three of these recorders will operate with dry-contact skin contacts, for example, with the subject's thumbs placed on the metal contacts.

 

Recordings in general (but not always!) are much cleaner, consistent, and more accurate if adhesive electrodes are used rather than the dry skin contacts that are built into the machines. The thumb/skin contacts are definitely more convenient, quicker, and produce good results with practice. But they also usually produce more variability and artifacts than one wants. Here are examples of comparable records with the thumb contacts held in a typical fashion; thumb contacts held with deliberate care in a gentle, steady, careful, and practiced manner; and with adhesive electrodes. There are more artifact noise and artifacts called baseline wander in the typical thumb contact example. (Original figure from excerpts of RMH results.)

 


Comparisons of outputs among the various devices and against standard 12-lead outputs

I considered attempting to show outputs from the devices in a side-by-side or overlaid manner, next to each other and in comparison with standard 12-lead outputs for similar records. However, there are too many possible comparisons, too many permutations, and it would be unwieldy to make such comparisons here. Thus, I will let you, the reader, decide what you want to compare and then either scroll down through the device descriptions to compare what I have provided for each or, if in more depth, see below in the fourth paragraph of this section (starting with "To compare among the devices ...") for suggestions.

In my description of each device I have included figures of their device-screen displays, computer-screen displays for uploaded records, and views of their hard-copy printouts. The figured printouts here, however, often do not provide very good resolution. Thus, in most cases I have also attempted to include links to pdfs of the printouts. [Links to pdfs not yet incorporated. They are coming.] The pdfs provide full-size printouts or, when viewed on a computer, can be zoomed in for larger views, including highly-magnified closeups. (Note: some of the pdfs are produced by the device software itself, some by using pdf printer software that is separate from the device, or, in some cases, by scanning printed copies of the printouts to pdf format.)

Note: Outputs of ECG records commonly start with a period of instability (wandering baseline and artifacts) but then typically stabilize. Ignore those initial unstable periods when they show up on the outputs displayed here.

To compare among the devices and standard pdfs, you can either (1) make printouts (be sure to print them to the same scale so the background 5 mm "big box" and 1 mm "small box" grids are the same) and then look at them side-by-side or, better yet, overlay them over a light source such as a light box or by holding them up to a window, or (2) compare the pdf views on your computer by putting the views side by side or overlaying them (including zoomed magnifications) with appropriate imaging software or by using PowerPoint or similar programs and making the background transparent for one or more of the views to be overlaid.

In the linked pdfs [not yet incorporated; they are coming] I include not only normal heart rhythms, for both a live subject (me) and a commercial simulator, but also some examples of irregular rhythms (or arrhythmias) including atrial fibrillation (afib) and premature ventricular complexes/contractions (PVCs), both of which I myself get from time to time.

Pdfs of standard 12-lead outputs for comparison with handheld device outputs. ... [Not yet incorporated. They are coming.] If you do not want to bother with the pdfs [or in the meantime before the pdfs are added], you can use the printout figures shown below the standard 12-lead computer screen views.

Examples of computer screen views, for comparison, of two PC-based standard 12-lead systems, Nasiff Associates, Inc., and WelchAllyn CardioPerfect. These recordings, incidentally, are from older (but similar to current) recordings from myself (as the subject also for these handheld devices) with a normal heart rhythm ("normal sinus rhythm" or NSR).

 

 

Examples of printouts (hard-copy) of standard 12-lead ECGs (top: Nasiff [from a different record than in the computer-screen view above, but similar and representative], bottom: WelchAllyn).

 

 

How to use these units in 12-lead and exercise contexts

It is possible to obtain additional lead information, in sequential manner, with some of these devices. (Not all of them work well for additional leads.) In some cases, one can obtain all 12-leads, which are often very comparable to what would be recorded with standard 12-lead systems. Most of the devices can also be used in exercise or what I refer to as "pseudo-stress test" situations. For further information and suggestions (along with the appropriate disclaimers), click here.

Sources for 1-lead handheld ECG recorders: See the listed link(s) at the end of each description or do a browser search for the names of the devices. Many of them are readily available online from the companies themselves, several medical device suppliers, dedicated distributors, sometimes on eBay, and perhaps on other sites such as Amazon.com. For a good source of some of them, also see Favoriteplus.com, the source from which I have gotten some of the units for testing (see Appendix re disclosures/transparency). 

 

Ongoing revisions and updates to devices and their software or apps!

Many, if not most, of the devices and their software/app packages are currently being revised and updated very rapidly, in several cases faster than I can keep up with! Thus, revisions to this web site may already be obsolete when they are posted. Anticipate that additional revisions to updates will take place as I have time available and can take care of them. Also check with websites of the various companies listed for the latest information and revisions -- hopefully they will be keeping their own sites current with the latest changes.

 

General note regarding ECG device user manuals and software from Chinese manufacturers and distributers

Many, if not most, current handheld ECG devices and software packages are made in, and often distributed from, China. The English of Chinese ECG device manufacturers and distributers is much better than my Chinese (which is zero!) and I have to give them credit. And some of the manuals and software programs for ECG devices from China have been written by persons in China with good English or originally written or subsequently edited and rewritten by other native English-speaking persons outside of China, so the writing is excellent. In many cases, however, the documents and software were written by someone for whom English is a foreign language, things are often lost or mangled in translation, grammatical and spelling errors are common, and phrases or terms (including medical) frequently don't make sense to a native English language user (including medical or other persons who are used to standard English ECG terminology). One person referred to the Chinese-accented English writing as "Chinglish". Most native English readers find it at best distracting, the meanings often difficult to understand, and sometimes just amusing or even wrong. I haven't bothered to point out which devices' manuals and software programs suffer from these problems, but will issue a general caution that native English language users should not be surprised when such problems are encountered, including difficulties trying to follow installation and operation instructions. (On the other hand, I find that many of the Chinese software programs install faster and with fewer hassles than American software!) You will have to do your best to live with language glitches when encountered, try to appreciate our language differences, and hope that future editions will be corrected by someone with a better command of English.

 


DEVICES TESTED

(in alphabetical order)

 


 

AliveCor

http://www.alivecor.com/

For their YouTube page with several videos, including news clips, see: http://www.youtube.com/user/Alivecor. For other numerous links, see their main page.

AliveCor is a smartphone ECG device and accompanying app for iPhones, Adroid, and IOS. It has recently been cleared for OTC purchase. It has 24hr/7day interpretation service available for users in the US. It operates through finger contacts built into the device.

It comes in various forms as either a smartphone case in different sizes that fit different phone models or as a small, convenient, handheld wireless device. Even the ones that are actually phone cases operate by wireless, so they also operate when simply near the phone (any phone of compatible operating system, regardless of size) and some users may prefer to use them not attached to the phone anyway. Thus, one can carry them separately or have them at hand and still use them with the phone app even if not using them connected to the phone as a phone case. One can use the system themself or communicate with a physician about the results. Or physicians can carry their own units for use on their patients.

The system, including the accompanying phone apps and computer web app, has numerous options, menus, and settings that can be easily changed, including settings for recording times that can range from 30 seconds to minutes to continuous. It is very flexible and rich in features including even built-in instructional menus that provide information about hearts, ECGs, and heart health. Thus, anyone new to the subject can learn from materials provided directly by AliveCor.

It includes an enhanced filter, one of the best I’ve seen, that produces very nice, smooth, ECG traces. If one wants to view the record without the enhanced filter, however, such as a cardiologist looking for very subtle patterns, you have the option to turn the enhanced filter off.

There are various arrangements that can be made to communicate through the system with one’s physician. And there are also options for getting recordings analyzed through AliveCor’s in-house cardiologists and ECG technologists 24/7 for modest per-use charges depending on the service chosen. (Charges beyond the initial purchase price are only for using their in-house analysis service. If not using that service, there are no per-use charges for recording, viewing and printing results, or communicating with one’s physician.)

Photo of the AliveCor package (using an iPhone 5 example), Quick Start Guide, and device. The example shown here is the smartphone case for an iPhone 5. The smooth metal contacts on the back surface of the case, as shown, are where one places fingers from the right and left hands during an ECG recording.

 comparative-handheld-alivecor-2.jpg (145400 bytes)

 

Display of phone app ready for recording. In this view, various menus are also shown at the side.

comparative-handheld-alivecor-3.jpg (114703 bytes)

 

AliveCor being used while recording by simply holding the smartphone case near the phone, not attached. If the case were to be attached to the phone as designed, one would be holding the phone in this manner. The finger contacts (electrodes) for obtaining the ECG signals are located on the back of the case, not visible in this picture but as seen in the first photo above.

 comparative-handheld-alivecor-1.jpg (104838 bytes)

 

Close-up view of display, from a stored recording.

comparative-handheld-alivecor-4.jpg (113403 bytes)

 

 Computer screen view of a section of the list of records.

 comparative-handheld-alivecor-5.jpg (97062 bytes)

  

Onscreen display (via pdf) of an uploaded record, closeup view for details.

 comparative-handheld-alivecor-6.jpg (163015 bytes)

 

Onscreen display (via pdf) of an uploaded record, left, and an interpretation (via pdf) from the AliveCor analysis service (this example: eCardio ECG technologist), right.

 comparative-handheld-alivecor-7.jpg (134754 bytes)

[Link to pdf for better resolution and additional examples, including a case of afib record and AliveCor cardiologist analysis.] [not yet incorporated; they are coming]

 

Device characteristics:

  • Physical: (Dimensions vary by smartphone model; weight approx. 1.4 oz)
  • Batteries: (smartphone)
  • Display screen: (Smartphone or tablet screen.)
  • Length(s) of recordings: can be set to different lengths, 30 sec, ... minutes, to
    continuous
  • Time to auto-shutdown: (depends on smartphone or tablet setting)
  • Additional cable-wires for adhesive skin electrode recording: no
  • Internal or memory-card storage capacity: (depends on smartphone or tablet
    memory)
  • Ability to add comments to recording files: yes: gender, birth date, symptoms,
    activity, and comments.
  • Device menus, options, flexibility, and ease of use: user friendly, easy to use as app with numerous features. It has an excellent advanced filter, which can be turned on or off (for unfiltered trace). When on, the filter removes a lot of the background noise, such as from skeletal muscles, and makes a very smooth ECG tracing. (Physicians might like the option of turning the filter off to search for possible subtle actual ECG details that might be present.)
  • Software or app menus and ease of use: (see above)
  • Printouts: Automatically made into pdf files by the system, which can then be
    viewed on the computer, printed, and saved separately for file or emailing to
    physician or others.
  • Cost: USD $199, viewing/printing/storing/sending records on own: no additional
    charge; analysis service: $12 for cardiologist within 24 hr, $5 for ECG
    technologist within 30 minutes, $2 for ECG technologist within 24 hr, per
    analysis. Analysis rates quoted are "introductory pricing".
  • Advanced recordings such as sequential 12-lead: no
  • Other aspects and comments: This is a feature-rich, flexible ECG device and
    app(s) 1-lead ECG system for home, office, and travel use by the general public
    with a physician prescription. It can also be used by physicians and other health-
    related personnel conducting recordings on their patients while with them. It
    records for periods of time chosen by the user, with the record then available for
    review or subsequent analysis, printing, saving, and/or sending.


Source: Through AliveCor, following their instructions, at http://shop.alivecor.com/shop/heart-monitor/.

 

 


 

 

Dimetek Micro Ambulatory ECG Recorder, DiCare-m1CP

http://www.dimetekus.com/Micro-Ambulatory-ECG-Recorder_p238.html
or
http://dimetekekg.en.ec21.com/Dimetek_Micro_Ambulatory_ECG_Recorder--7968033_7968034.html

The DiCare-m1CP is a small, compact ECG device with a unique push/roll navigation button/wheel. It has several functions, including quick recording via finger contacts plus Holter, event, and monitoring modes for longer recordings using lead-wires and adhesive skin electrodes. It is one of the smallest and lightest ECG devices available. It is easily worn with the included pouch and necklace cord for longer, Holter-style recordings, and easily carried in a purse or briefcase/backpack, kept in a desk or bedroom drawer, or easily stored in a small space.

It is a stand-alone device with user-managed records on the user’s own computer (not on a server or in the cloud elsewhere). If the records are to go to a patient's physician, the patient has to either carry the printouts or send email attachments directly to the physician.

This device is very user friendly to operate but requires that the user by guided by his/her physician, be a physician, or otherwise be competent and savvy with ECGs to deal with the records.

When worn as a Holter unit (or event or monitor mode) in the necklace pouch, its small size and light weight allow it to be used unabtrusively and unnoticeablely under clothing during exercise and daily activities. Activity can introduce movement artifacts to the traces but there are still usually many segments of excellent series of heartbeats, particularly when one is inadvertently or deliberately paused or otherwise not moving vigorously, that can be read as good ECG waveforms. The Holter, event, and monitoring functions of this device are perhaps the most important features, with the ability to do quick recordings with the finger contacts as somewhat of an added bonus.

This is one of several products from the company, including at least two portable ECG recorders, available for home use and recently FDA approved.

There is much more information and at least one video available at the websites listed above. There are also several downloadable materials available at: http://www.dimetekus.com/download.

The downloadable items include an app for the android smartphone (see "ECGViewer_android.rar in the download list). I myself have not tested or used that app as I don't have an android phone, but it is described as providing instant communication, ECG data transfer, reading of ECGs, and early warning.

Photo of materials received with purchase: shipping package, User’s Quick Start Manual, soft cloth pouch and necklace for wearing during long recordings, lead-wire cables, the ECG device, and micro card reader for transferring files to the computer. The micro card that comes with the unit, in addition to storing recordings, also includes the software, a full user manual, and instructional videos. Also included with the original purchase (but not pictured) is a supply of adhesive skin electrodes for use with the lead-wire connections.

comparative-handheld-dimetek-m1cp-1.jpg (138811 bytes)

 

Photo of device at startup Quick option, ready to begin recording with a push of the wheel-button which can be seen at the bottom of the device. (Photo taken under low light to better highlight the display. The display is better than shown here. It is mirror-like and difficult to photograph without reflections.) The display is lighted and works well in the dark, such as during emergency uses at night without turning on room lights.

comparative-handheld-dimetek-m1cp-2.jpg (46233 bytes)

  

Photo of recording using the finger/hand contacts. Recordings can also be made using the lead-wire cable and adhesive skin electrodes. The unit is easily worn in the soft cloth pouch as a necklace for long, Holter-style recordings. (As noted in the photo above, screen displays are brighter and better than they appear in these pictures. Because the display surface is so reflective, it has to be photographed under low light or tipped to avoid distracting reflections.)

comparative-handheld-dimetek-m1cp-3.jpg (113840 bytes)

 

Two views of a stored ECG record on the device display. Displays of recordings can be scrolled through using the wheel at the bottom. It shows the average waveform at the end of scrolling.

comparative-handheld-dimetek-m1cp-4.jpg (25467 bytes)

 

View of computer screen with software running and with a pop-up list of records (by clicking the "Open" button), ready to choose a record for opening. (Note: I changed the names of the files in their folders to reflect conditions of the recordings for my convenience in working with the files later. The system saves the recordings under shorter names by time of recording etc.)

comparative-handheld-dimetek-m1cp-5.jpg (128198 bytes)

 

Computer screen view of section of a recording. Comments can be added to the record by clicking on the box at the bottom just to right of center, adding up to 30 characters of comments as shown, then clicking the "save" checkmark button to the right of the comments box. There are several options within the software for different views and analysis, and a scroll bar at the bottom for scrolling through long records.

comparative-handheld-dimetek-m1cp-6.jpg (135240 bytes)

 

Printed example of a recording (same as in the computer screen view above.

comparative-handheld-dimetek-m1cp-7.jpg (260270 bytes)

 

[+Link to pdf for better resolution and additional examples, including examples with PVCs and afib.] [not yet incorporated; they are coming]

 

Device characteristics

  • Physical: 3 1/2 x 2 3/8 x 5/8 in (90 x 61 x 17 mm), 2.9 oz (82 g) (including batteries and micro memory card)
  • Display screen: black-&-white, appox. 2 x 1 in (50 x 25 mm)
  • Length(s) of recordings: 24 to 48 sec (settable) for Quick Recording with the finger contact electrodes or, if using the lead-wires for other functions, “continuous”, that is, until whenever stopped (24 hr default)
  • Time to auto-shutdown: display turns off after idle for about 15 seconds but the device itself remains on if recording; if not recording or being used otherwise, the device automatically turns off after 1 minute
  • Additional cable-wires for adhesive skin electrode recording: yes, a 2-wire system
  • Internal or memory-card storage capacity: the internal storage can only hold one 24 second quick mode recording, but the included 2GB micro SD memory card holds up to 300 hours of recordings; thus, since a single recording can go up to 32 hours, the SD card holds up to at least 8 recordings of 32 hours (or many hundreds to thousands of short-duration recordings)
  • Ability to add comments to recording files: yes, up to 30 characters per record (see notes with the figures)
  • Device menus and ease of use: clear/intuitive and very user friendly; there are several modes for recording including Quick, Holter, Event, and Monitor (also see “Other aspects and comments” below)
  • Software or app menus and ease of use: clear/intuitive and very user friendly
  • Printouts: can be sent to selected printer (including pdf if you have separate pdf printer software).
  • Cost: varies considerably depending on supplier, whether they are in stock, and if on sale. Average cost is around $300 but I’ve seen them range all the way from $150 and in the $200’s to $359!
  • Advanced recordings such as sequential 12-lead: yes (more on this to be posted later, if and when I get around to it)
  • Other aspects and comments: The device and software has undergone updates and improvements following problems with such things as printing, computer screen displays on different operating systems, etc., so that the system now works much better and more reliably.

    The Monitor mode supports visual and audio indication of heartbeats and real-time alarms when the heart rate is out of the present range (normally 60-100 beats per minute).

    Finding the software, manuals, and instruction videos can be a challenge for a new user until one understands that it is on the micro memory card, removes the card from the unit when it arrives, and uses the card reader to view things on the computer. I put together my own figure for accomplishing that, as shown:

comparative-handheld-dimetek-m1cp-8.jpg (32329 bytes)

  

Note that, to remove the micro memory card, any batteries that are in place have to be removed first, after which the date and time need to be reset when the batteries are reinserted.

Sources: Via the company’s web site: http://www.dimetekus.com/Micro-Ambulatory-ECG-Recorder_p238.html (they ship internationally and quickly) and http://dimetekekg.en.ec21.com/Dimetek_Micro_Ambulatory_ECG_Recorder--7968033_7968034.html. The device is also available through numerous suppliers (although they do not all stock them regularly and there may be shipping delays); do a web search for its name.

 


 

 

ECG Check

http://cardiacdesigns.com/

For a video introduction to the device or to purchase, see: http://www.ecgcheck.com/. Physicians and patients can get support from Cardiac Designs by emailing info@cardiacdesigns.com or by calling 512-582-2453 during business hours. 

The ECG Check device is a low-cost phone case and accompanying app that works with iPhones 4s and newer. ECG Check is simple-to-use and provides straightforward ECG information. Despite its low cost, it provides highly accurate 1-lead ECG recordings. 

The ECG Check system is available in several modes: OTC, prescription, and physician. ECG Check’s OTC mode is designed with general-public users who are not interested in looking at their ECG traces, but who just want to take a quick recording for the basic information for themselves and/or which they can send simply and directly from their iPhones to their physicians. 

Users wanting to upgrade to the prescription mode can obtain the prescription from their physician then easily submit an image of their prescription when prompted by the app, using the camera on their iPhone. Physicians wanting to upgrade to physician mode can submit their NPI code through the app. 

Users with their ECG Check systems upgraded to full functionality, beyond OTC mode, are still very easy to use. Patients record ECGs and can send the records to their physicians the same way in both OTC and prescription modes. However, in prescription mode, the patient’s can also view the full recordings including the waveforms on the iPhone (including during recording) and in the results (in pdf format) sent to themselves. The recordings can be downloaded from email, viewed, printed, and filed as electronic medical records (EMR). 

ECG Check is designed to fit on iPhones. But because the system employs Bluetooth to communicate with the device, it works whether used as an actual iPhone case or when just held within range of the iPhone, not attached (regardless of whether the 4s/5 case is the same as the iPhone version). It is also possible to use ECG Check with iPad 3 or newer. 

ECG Check reports show beat-to-beat heart rates for each pair of neighboring beats. They can be viewed in the saved records on the iPhone, on a sent pdf file opened on a computer screen, or printed. I found that to be a really nice feature, which is especially useful for evaluating beat irregularities, or arrhythmias, such as afib, PVCs, PACs, etc.

 

Photo of materials received with purchase: plastic packaging, Quick Start Guide, and iPhone case/device (plus a downloadable app). The case is shown from the back, where the shiny metal finger-contact electrodes can be seen.

comparative-handheld-ecgcheck-2.jpg (123604 bytes) 

 

Photo of app startup, ready to begin recording.

comparative-handheld-ecgcheck-3.jpg (91091 bytes)

 

 

 

Recording while holding the device near the phone, not directly attached.

comparative-handheld-ecgcheck-1.jpg (126288 bytes)

  

View of a section of a list of recordings on the iPhone.

comparative-handheld-ecgcheck-4.jpg (95696 bytes)

 

View of a stored ECG record on the iPhone. (Note the PVC at the start of the record.)

comparative-handheld-ecgcheck-5.jpg (104350 bytes)

  

Close-up of a section of recording, as expanded on the iPhone. The automatically measured beat-to-beat heart rates can be seen in this view.

comparative-handheld-ecgcheck-6.jpg (112491 bytes)

 

Close-up view of a section of a pdf report, as viewed on computer screen monitor. The beat-to-beat measures of heart rate between neighboring pairs of beats can be seen in this view.

comparative-handheld-ecgcheck-8.jpg (137281 bytes)

 

Printout from a sent pdf record.

comparative-handheld-ecgcheck-7.jpg (122809 bytes)

 

[+Link to pdf for better resolution and additional examples, including examples with PVCs and afib.] [not yet incorporated; they are coming]

 

Device characteristics

  • Physical: (Dimensions vary by iPhone model; weight approx. 1.2 oz)
  • Display screen: (iPhone [or iPad] screen.)
  • Length(s) of recordings: can be set to different lengths, 30 sec, 40 sec, 1 minute, or 2 minutes
  • Time to auto-shutdown: (depends on iPhone [or iPad] setting)
  • Additional cable-wires for adhesive skin electrode recording: no
  • Internal or memory-card storage capacity: (depends on iPhone [or iPad] memory)
  • Ability to add comments to recording files: only gender and age; comments can only be added by changing the name of the saved record’s pdf file name to include key aspects
  • Device menus and ease of use: simple menus, clear/intuitive and very user friendly
  • Software or app menus and ease of use: (see above)
  • Printouts: automatically made into pdf files by the system, which can then be sent by email from the phone app, viewed on the computer, printed, and saved separately for file or emailing to physician or others
  • Cost: MSRP: USD $129; no additional per-use charge for recording, viewing/printing/storing/sending records
  • Advanced recordings such as sequential 12-lead: no
  • Other aspects and comments: This is a low-cost, simple, quick and easy, no-frills 1-lead ECG device. It is excellent for anyone wanting that. The automatic beat-to-beat heart rate measurement is a very nice feature.

 

Sources: http://www.ecgcheck.com/ and Amazon.com.

 


 

HeartCheck Pen

http://www.theheartcheck.com/products/pen_device.html

For the the HeartCheck Pen YouTube introduction to the device, see: http://www.youtube.com/watch?v=Pk_dNPKmDD0. For other links: YouTube page with all of their videos, and an Executive Informational Overview report on CardioComm Solutions, Inc..

The HeartCheck PEN ECG device is the first FDA cleared and Health OTC handheld ECG recording device. It also has 24 hr 7 day a week full ECG interpretation service by a physician. The name of the cloud-based service is GEMS Home. The HeartCheck PEN manufacturer, CardioComm Solutions, offers the first ECG interpretation free; subsequent ones cost a modest amount. In addition to the full interpretive service of an in-house physician, they also offer a lower-cost triage service with readings by certified ECG technologists.

Because it is OTC and a prescription is not required, anyone can get it, use it themselves (including with the interpretation service when desired or needed), and/or communicate the results with their physicians. Contact with one’s own physician is not required but always recommended unless one is certain that there are no heart-health concerns or if one is otherwise already connected with a cardiologist and simply wants a handheld device for your own use.

The device operates through finger contacts, is small, compact, and easily carried in a pocket, purse, briefcase, or kept readily at hand. It includes a clip on the back for a shirt pocket.

 

Package of materials received with purchase: plastic shipping and storage box (upper left), cable for uploading stored records to computer (upper right), printed manual (lower left), and HeartCheck PEN device (lower right). Software is downloaded from online.

 comparative-handheld-heartcheckpen-2.jpg (131066 bytes)

 

Recording an ECG.

comparative-handheld-heartcheckpen-1.jpg (101251 bytes)

 

Close-up view of display screen, from a stored recording.

comparative-handheld-heartcheckpen-3.jpg (124570 bytes) 

Computer screen image of software menus at startup.

comparative-handheld-heartcheckpen-4.jpg (136826 bytes)

 

Computer screen view of section of list of records, with one highlighted, to view report and/or submit for monitoring review (see next images).

comparative-handheld-heartcheckpen-5.jpg (141946 bytes)

 

Onscreen display (via pdf) of an uploaded record, closeup view for details.

comparative-handheld-heartcheckpen-7.jpg (151946 bytes)

 

Onscreen display (via pdf) of an uploaded record, left, and an interpretation (via pdf) from the GEMS Home service, right.

comparative-handheld-heartcheckpen-6.jpg (115694 bytes)

 

[Link to pdf for better resolution and additional examples.] [not yet incorporated; they are coming] 

 

Device characteristics

  • Physical: 5 3/16 x 1 3/16 x 3/4 in (132 x 30 x 20 mm), 2.5 oz (72 g)
  • Display screen: 1 x 1/2 in (25 x 12 mm), color, lighted so can be used in dark
  • Length(s) of recordings: 30 sec
  • Time to auto-shutdown: choice of 10, 30, 60, or 120 sec (no manual “off”, have to wait for auto-shutdown)
  • Additional cable-wires for adhesive skin electrode recording: no
  • Internal or memory-card storage capacity: 20 records
  • Ability to add comments to recording files: yes, by “Diary Entry” for uploaded records
  • Device menus and ease of use: user friendly, easy to use -- recording, review/playback stored recordings, system setup (date and time, sound, speed of playback, filter, auto-shutdown time
  • Software or app menus and ease of use: several menus and options that are intuitive and user-friendly
  • Printouts: Automatically made into pdf files by the system, which can then be viewed on the computer, printed, and saved separately for file or emailing to physician or others.
  • Cost: MSRP: USD $259, viewing/printing/storing/sending records on own: no charge, Interpretation service: no charge for first interpretation, $12.50 each thereafter, Triage Service: $4.99 per analysis.
  • Advanced recordings such as sequential 12-lead: no
  • Other aspects and comments: One of the smallest devices, for convenience and portability; useful for quick recordings for own review/monitoring or to send to physician. The display screen is very small, but easily read and the small screen is a consequence of a small device.

 Sources: http://www.theheartcheck.com/Portable-EKG-Machines.htm and several other online sources (do a search)

 


 

InstantCheck

http://www.dcbiomed.com/webls-en-us/InstantCheck:V4.0.html

One of the first three handheld devices that I tested and reported. It is still available, still the same quality, and still very popular among users. Earlier problems, such as occasional failure of the cable between the main unit and the display screen in the lid, have been corrected (and the company may offer to replace or repair older units that fail even after the standard warranty period). I believe the device has been updated since my original review and I know that the software has gone through several revisions.

InstantCheck is a more complete and more expensive, slightly smaller but slightly heavier cousin of ReadMyHeart (see below), manufactured by the same company (DailyCare Biomedical Inc.) The recorder has several more options than RMH, a complete menu, and displays the actual ECG tracings during recording and review of records. It also has computer software that is further developed and refined (while still being very user friendly) compared to RMH.

IC's display of the actual ECG as a monitor during recording and subsequent review of records permits a reading of the ECG by a cardiologist or anyone who can read ECGs, as well as confirming that a good record is being obtained during the time of recording. IC is good for anyone who is more serious about ECG recording and/or who wants good records. The main tradeoff is that it also costs more than most of the other handheld devices.

 

 

Display of a recorded ECG.

 

View of computer screen, software, and an uploaded record, with added comments.

Example of a printout.

Device characteristics:

  • Physical: 4 7/8 in. x 3 1/8 in. x 7/8 in. (12.3 cm x 7.8 cm x 2.3 cm); weight with batteries approx. 5.5 oz. (~140 gm)
  • Batteries: 2 standard 1.5 v size AAA
  • Display screen: real-time monitor plus heart rate during recording; then, after recording it shows record number, date and time, HR, ST, QRS, and a simple interpretation of the recording; display is not lighted but the recorder includes a red light that displays on the panel during recording, which makes it useful for knowing when a recording is finished at night in the dark without room lights
  • Length(s) of recordings: 30 seconds following a brief initialization time
  • Time to auto-shutdown: 1 minute from last time one of the buttons is pressed (and after a recording ends, if no further action taken)
  • Additional cable-wires for adhesive skin electrode recording: yes, 2-wire
  • Internal or memory-card storage capacity: 100 records
  • Ability to add comments to recording files: yes
  • Device menus, options, flexibility, and ease of use: starts up with message and ability to either go to the menus or start recording as desired; easy to use and thorough menus, including scrolling down through the records and review of individual records -- with stopping and restarting as desired; records are retained in the recorder after upload/transfer to computer and may be deleted (all at a time) from or kept in the recorder as desired; audible beep at startup and shutoff so one knows when it comes on and goes off
  • Software or app menus and ease of use: excellent software, including printout of one, full, 30 second record per page, with standard grid and measurements
  • Printouts: can be printed from the uploaded records using the software; standard grid and measurements
  • Cost: around $500
  • Advanced recordings such as sequential 12-lead: yes, using the lead wires
  • Other aspects and comments: Compact for easy carrying and storage; quick start and convenient, with option to go either to the menus or start recording; display of actual ECG monitoring during recording (and subsequent review of records); numerous options available through the user-friendly menus; easy transfer of data to computer with excellent analysis and printout; I myself have used the device many times over a several-year period and we have used it in university lab courses with students; the only long-term problem that I encountered in the (original) units I used is that batteries go dead when left in it unused after several days or a few weeks, thus, it needs to be stored with the batteries out or have the batteries replaced after storage (along with resetting the date and time). However, I heard from another user who did not have that problem. His unit, apparently a revised version, went for several months between the need to change batteries, so the problem may have been fixed. (I would appreciate hearing from others who get or already have the InstantCheck as to whether or not they encounter short battery lives. If it is no longer a problem, I'll drop these comments.)


Sources: http://www.favoriteplus.com/instantcheck-handheld-ecg-ekg-monitor-fp-ich.php,   http://www.dcbiomed.com/webls-en-us/InstantCheck:V4.0.html, and several other online sources.

 


 

 bd10268_.gif (177 bytes)  MD100E -- This is a good updated device (although the software is still a little funky and a head-scratcher until you figure it out by carefully studying the software manual that comes on the software CD and then experimenting with the menus etc.). I tested but do not recommend the earlier updates, such as MD100B, because of a number of problems. For links and sources, do a browser search for "md100e ecg", e.g.:
https://www.google.com/#q=md100e+ecg.

[Description being revised and expanded; photos/figures being added]

 

Device characteristics:

  • Physical:
  • Batteries:
  • Display screen:
  • Length(s) of recordings:
  • Time to auto-shutdown:
  • Additional cable-wires for adhesive skin electrode recording:
  • Internal or memory-card storage capacity:
  • Ability to add comments to recording files:
  • Device menus, options, flexibility, and ease of use:
  • Software or app menus and ease of use:
  • Printouts:
  • Cost:
  • Advanced recordings such as sequential 12-lead:
  • Other aspects and comments:


Source:

 


 

PC-80

http://www.creative-sz.com/Easy-ECG-Monitor/Easy-ECG-Monitor-PC-80A.html

One of the first three handheld devices that I tested and reported. It is still available and, from what I understand, still liked by many persons, particularly elderly and those new to such devices who want low cost and only the most basic of systems.

The PC-80 may be about to be discontinued and replaced by its newer sibling, PC-80B Color, which is considerably different, has many added features, more flexibility, and, has corrected some of the drawbacks of the original PC-80. For details on the PC-80B Color, see next device described further below.

The PC-80 is small, lightweight, robust, and handy. It is for someone on the go wanting a unit that takes up little space and for fast recordings. It would take up little room in a briefcase or luggage or even fit easily in a purse.

In its original version (including the software), it is most useful for determining basic arrhythmias rather than full ECG analysis. The software and printouts provide the least useful ECGs for resting ECGs but seems to allow arrhythmias to show through background noise slightly better, that is, it seems less vulnerable to ECG artifacts than some of the other devices. It accentuates or focuses on the R wave, with diminuation of the other waves, including T. It represents an early stage of software developent. Aside from software issues, it is a great stand-alone ECG recorder that records and stores ECGs for later review by oneself or a cardiologist. As with many of today's devices, one can take or send the printouts to their physician or take in the device itself to show the results on the recorder's display screen..

PC-80 starts fast, goes right into recording, and has a fast (30 second) auto shutoff if no further action is taken. It has menus with several options and a rocker panel to select among various choices. Because it starts recording at powerup, one has to either do a recording at the start or wait for it to go through the routine before accessing the menus. The advantage is that it gets right to recording for someone that wants to record as quickly as possible. The downside is that going into recording first can get in the way of going to the other functions.

 

 

View of display screen.

 

Computer screen view of software and an uploaded record. The software uses it's own, basically nonstandard grid and does not provide measurements of ECG waves, just HR and a simple interpretation of whether the ECG is "normal" or not.

Example of a printout, very basic, without measurements beyond HR and without the option of including user comments (also with its own, nonstandard grid, although still at the standard 25mm/sec speed).

But the PC-80 does have a summary feature for printing out summary ECGs for all records, which is very nice.

Device characteristics:

  • Physical: 4 3/8 in. x 2 1/8 in. x 5/8 in. (11.2 cm x 5.5 cm x 1.7 cm); weight with batteries approx. 4 oz. (<100 gm)
  • Batteries: 2 standard 1.5 v size AAA
  • Display screen: active real-time monitor while recording; after recording it displays record number, date and time, HR, a smiley (or sad) face, and a simple interpretation of the recording after it's completed; at the press of button for screen lighting, the recorder can be used and viewed at night (when many arrhythmias commonly occur) without needing to have room lights on
  • Length(s) of recordings: 30 seconds
  • Time to auto-shutdown: after 30 seconds from last time one of the buttons is pressed (or analyzing and storing a recording, if no further action taken) -- which is not much time and one has to be quick or else restart the device for using functions beyond recording
  • Additional cable-wires for adhesive skin electrode recording: 3-wire
  • Internal or memory-card storage capacity: 24 records, after which new ones replace the first ones; records are retained in the recorder after upload/transfer to computer and may be deleted (one at a time) from or kept in the recorder as desired
  • Ability to add comments to recording files: no
  • Device menus, options, flexibility, and ease of use: starts up with message and instructions then starts recording; thorough menu, including scrolling down through the records and review of individual records -- with stopping and restarting as desired
  • Software or app menus and ease of use: The original software has easy transfer/upload of data from the recorder and moderately user friendly menus, but at the same time is also somewhat awkward, does not use the standard grid pattern (although it is still 25mm/sec), and does not allow entering user notes and comments to supplement the records. The software also seems to accentuate the R wave at the expense of other waves, such as the T wave, which makes standard reading of the output difficult (or impossible in some cases).
  • Printouts: can be printed from the uploaded records using the software
  • Cost: less than USD $200 (varies by source)
  • Advanced recordings such as sequential 12-lead: yes, via lead wires, but low quality and not really useful for normal 12-lead analyses (see PC-80B for useful, high quality advanced recordings)
  • Other aspects and comments: The original versions of the PC-80 device and software have several drawbacks as discussed above (and other drawbacks that I have not bothered to list); these have been more than corrected in subsequent versions of both the device and software, as described for the next device, PC-80B Color, below. The original PC-80 is still useful primarily for persons (including some elderly) wanting something quick and easy for heart rate and a rough look at possible arrhythmias. Because the newer PC-80 versions, particularly the PC-80B Color, are so improved in many ways, the original PC-80 is likely to be discontinued in the near future. If you want one, you might need to get it before current stocks are gone. (Note: there may also be other brands and models, not listed on this website, which are roughly similar to the PC-80 in their simplicity, low cost, and representing early stages of handheld ECG device and software development.)


Source: The PC-80 is still available at http://www.favoriteplus.com/portable-handheld-ecg-ekg-monitors.php and, I think, the manufacturer at http://www.creative-sz.com/Easy-ECG-Monitor/Easy-ECG-Monitor-PC-80A.html. They are likely also available from other online sources.

 


 

PC-80B Color  

http://www.creative-sz.com/Easy-ECG-Monitor/Easy-ECG-Monitor-PC-80C.html
or
http://www.creative-sz.com/Tele-healthcare-Network/PC-80B-Bluetooth-Easy-ECG-Monitor.html

This is the latest version of the PC-80, one of three different handheld ECG devices that I originally reviewed in 2006. At the time, I commented: "It would be nice if one could somehow combine the best of all three [different handheld devices] into a single unit, for example, something like a PC-80 with its size, lighted display, and rocker panel for selecting among menus, but with longer time before auto-shutoff and all of the better features and superior software of the IC." This latest version essentially accomplishes just that, plus having a large, well-lighted (so it works good in the dark) color display, options for different lengths of recording including continuous (and can even be used like a Holter monitor!), new and added features in the software, plus options for USB cable, Bluetooth wireless, or ZigBee for uploading records to the computer.

The PC-80 and its software have gone through many revisions, updates, and improvements, to the point that it is one of the state-of-the-art handheld ECG devices (IF you get the latest version and software [see note at end of the section] and know enough about ECGs to be able to use it).

The latest software is very functional and user friendly/intuitive (once you figure out the correct version to use!, see note at end). The software is sophisticated with many features, including an easy built-in caliper for measuring parts of waveforms. The device has both finger contacts and lead-wire cables.

The PC-80B Color and its software is stand-alone, user-managed, up to the user to communicate with the physician (or be a physician), and the user needs to be somewhat ECG savvy.

Photo of materials received with purchase: shipping package, plastic box with padding, User Manual, Quick Guide, Practical Use guide (not shown in photo), the device with a leather carrying case, software disk, lead-wire cables, and upload cable (for the USB option).

 comparative-handheld-PC-80B-C-1.jpg (142954 bytes)

 

 Photo of device startup menu, ready to begin recording with a push of the button.

 comparative-handheld-PC-80B-C-2.jpg (130745 bytes)

  

Recording using the finger/hand contacts (recordings can also be made using the lead-wire cable and adhesive skin electrodes). Screen displays, incidentally, are brighter and better than they appear in these pictures. The display surfaces are reflective and had to be tipped for photos to avoid distracting reflections.

comparative-handheld-PC-80B-C-3.jpg (102809 bytes)

  

View of a stored ECG record on the device display (including a scale at the bottom indicating the segment being displayed). Display includes background grid markings.

comparative-handheld-PC-80B-C-4.jpg (118793 bytes)

 

View of section of a list of records (left panel), a recording (normal sinus rhythm, NSR, plus a few PVCs), and menus etc. on the computer screen while using the software. An onscreen caliper allows one to measure various parts of the waveform of a selected beat, as shown, by moving the red and black markers. By right-clicking the box of the selected beat, one can get a zoomed, pop-up box view of that beat, as shown. There are several options and views available (see examples of others below). The software has much utility, is very flexible, and is very intuitive and easy to use with features normally seen only in much more expensive PC-based 12-lead and Holter systems.

comparative-handheld-PC-80B-C-5.jpg (160585 bytes)

 

Here is a section from a long recording of an episode of atrial fibrillation (afib) plus it includes a PVC (second line, obvious). The sliding page bar at the bottom right allows one to scroll through the whole record. Also see the next figures.

comparative-handheld-PC-80B-C-6.jpg (161182 bytes)

 

With the "All ECG Wave" tab clicked, one gets the full disclosure of a recording, in this case, a long recording of an afib episode.

comparative-handheld-PC-80B-C-7.jpg (232415 bytes)

 

Continuing with the afib recording shown above, the afib converted on its own during the course of the recording. By using the "ECG Analysis" tab, which shows heart rate (HR) trend, one can easily see the point of conversion toward the end of the recording when the rate which has been fluctuating around 130 drops to around 100.

comparative-handheld-PC-80B-C-8.jpg (158443 bytes)

 

And the afib with its conversion is also seen when plotted in another way by clicking on the "Irregular Rhythm Trend" tab, as seen here.

comparative-handheld-PC-80B-C-9.jpg (159468 bytes)

 

Printed example of a recording (NSR plus some PVCs).

comparative-handheld-PC-80B-C-10.jpg (137777 bytes)

 

[+Link to pdf for better resolution and additional examples.] [not yet incorporated; they are coming]

  

Device characteristics

  • Physical: 5 x 2 3/4 x 3/4 in (126 x 68 x 20 mm), 4.1 oz (118 g)
  • Display screen: color, 2 1/4 x 1 1/2 in (57 x 39 mm)
  • Length(s) of recordings: 30 sec for “quick measurement” with the finger contact electrodes or, if using the lead-wires, “continuous”, that is, until whenever stopped
  • Time to auto-shutdown: 35 sec when there is no operation
  • Additional cable-wires for adhesive skin electrode recording: yes
  • Internal or memory-card storage capacity: 1200 30-second records or up to 10 hr continuous recording
  • Ability to add comments to recording files: yes
  • Device menus and ease of use: clear/intuitive and very user friendly
  • Software or app menus and ease of use: numerous features and menus, all clear/intuitive and very user friendly
  • Printouts: can be sent to selected printer.
  • Cost: around $300
  • Advanced recordings such as sequential 12-lead: yes (more on this to be posted later, if and when I get around to it)
  • Other aspects and comments: State-of-the-art 1-lead (with the possibility of doing sequential other leads), handheld ECG device with very sophisticated but intuitive and easy-to-use software. Both the device and software have gone through numerous revisions and improvements since the original PC-80.

    Notes and cautions:
    This device seems to be available in different versions under a confusing array of similar names related to “PC-80B” (and “Prince 180B”, which I think is similar if not the same device under a different name)! The specific one that I reviewed here is referred to by the originating company (Creative Medical, Shenzhen, China) as both “PC-80B Color” and “PC-80B Color Bluetooth” although not all of the units called “Bluetooth” have the wireless Bluetooth connection; some may have and connect to a computer by USB or ZigBee options! There are also [earlier?] versions of PC-80B (and Prince 180B) that have a SD memory card slot but do not have all of the features (as well as I can determine from the descriptions) of the one with the color display and wireless option. This latest one should at least be called PC-80C (which the company also uses in one of the web links for it and some sellers refer to it as PC-80B-C).

    The device appears to have evolved and divided into more options and versions faster than its name has been able to keep up! Thus, I urge care and caution that an interested buyer be very careful when purchasing a unit to make sure you carefully specify or shop for and get the specific one you want. The one I tested was “PC-80B Color” (with emphasis on “Color” in the name) with USB connection, not wireless or ZigBee.

    As a final note of caution, the software disk that comes with the latest version may also have earlier versions of the software included on the disk with little indication as to which one should be used! I had to use the “wireless” version of the software even though my specific unit was USB, not wireless! And the user manuals seem to be a mixture of versions. The confusion over software version may have led to poor reviews of the device by other persons on other web sites.

    Hopefully the company will clean up the current mess. (I understand they are working on it, based on my reports to them, and I’ll be able to delete these notes and cautions.) In the meantime, be careful so you get exactly the version you want when purchasing and then select the correct software version on the disk when installing.

 

Sources: See the links to the company at the start of this section. The PC-80B color will become available from Favoriteplus.com after their stock of the original PC-80s are sold out. It is also available from numerous other sources, including US suppliers and is often listed on eBay – do a web search for it.

 

 


 

bd10268_.gif (177 bytes)  (printing) ECG/EKG-80A (may also show up under different names and is available from international sources and some US suppliers) that is yellow-colored, rounded at one end, flat at the other, and outputs the results using a built-in, narrow-strip printer. It works good if one wants narrow-strip printed output, such as for insurance examiners, and without uploading to a computer or file saving. I'll try to provide details in a future update. I think the main source is CONTEC Medical. Note that this is a large company that also produces many other ECG devices, including a variety of handheld units as well as various 12-lead and Holter devices. Scroll down in their ECG link to see the yellow printing unit and also browse their many other items (of which the printing unit is the only one that I've seen and tested so far)
http://www.contecmed.com/index.php?option=com_virtuemart&Itemid=605

 

[Description being revised and expanded; photos/figures being added]

 

Device characteristics:

  • Physical:
  • Batteries:
  • Display screen:
  • Length(s) of recordings:
  • Time to auto-shutdown:
  • Additional cable-wires for adhesive skin electrode recording:
  • Internal or memory-card storage capacity:
  • Ability to add comments to recording files:
  • Device menus, options, flexibility, and ease of use:
  • Software or app menus and ease of use:
  • Printouts:
  • Cost:
  • Advanced recordings such as sequential 12-lead:
  • Other aspects and comments:


Source:

 


 

ReadMyHeart

One of the first three handheld devices that I tested and reported. It is still available and still liked by many persons, particularly elderly and those new to such devices who want only the most basic of systems.

ReadMyHeart is a low cost, lightweight recorder designed to be convenient and for use by an average person with minimal knowledge of reading ECGs, that is, for someone who doesn't need to read or monitor the tracings as they are being recorded.

 

 

The ECG tracings that appear on the display are NOT the actual ECGs but only simple icons that blink on and off during recording. For a display of the actual ECGs during and after recording, see the InstantCheck and PC-80.

 

ReadMyHeart software computer-screen view. Excellent ECG traces, very user friendly, and includes individual trace or average measurements.

ReadMyHeart printout. It includes 3 records at a time. (These particular examples represent leads I, II, and III respectively, from using the lead wires in appropriate fashion. That information was included in the records and displays on the computer screen but, because of the glitch in the system's software, described in the characteristics below [and perhaps corrected with recent revisions of software], did not print out on the hard copy such as shown in this figure.)

 

Device characteristics:

  • Physical: 5 in. x 3 1/4 in. x 3/4 in. (12.5 cm x 8.5 cm x 2.2 cm); weight with batteries approx. 5 oz. (~130 gm)
  • Batteries: 2 AAA
  • Display screen: record number, date and time, HR, ST, QRS, and noise indicator for records that need to be remeasured; instructions for operation and normal range of values included on inside of lid
  • Length(s) of recordings: 15 seconds
  • Time to auto-shutdown: after 2 minutes from last time one of the buttons is pressed (about a minute and a half after a recording is started, if no further action taken)
  • Additional cable-wires for adhesive skin electrode recording: yes, 2-wire
  • Internal or memory-card storage capacity: 30 records
  • Ability to add comments to recording files: (Not sure regarding latest version of software, it may have been revised. The version I tested [2006-2008, original version] allowed comments, "notes", to be entered into the record and displayed on the computer screen but then did not print on the printout. That glitch may have been corrected by now; the device is currently available in version 2, but I have not tested that version.)
  • Device menus, options, flexibility, and ease of use: simple and straight-forward, limited -- just the buttons shown
  • Software or app menus and ease of use: excellent, user-friendly, easy to upload records
  • Printouts: can be printed from the uploaded records using the software; printout show 3 records per page, with standard grid and measurements
  • Cost: less than USD $200 (varies with source)
  • Advanced recordings such as sequential 12-lead: yes, using the lead wires
  • Other aspects and comments: Quick start and convenient to record ECGs. Display not lighted and, thus, requires a room light for operation at night, to know when a recording is finished and to see results. The display shows blinking ECG traces during recording, but they are just icons, not the actual tracings being recorded. The software and uploaded ECG recordings are remarkably good, actually excellent, and very useful for reading by a cardiologist or anyone who is familiar with reading ECGs. Records are automatically deleted after upload/transfer to computer.


Sources: http://www.favoriteplus.com/readmyheart-handheld-ecg-ekg-monitor-fp-rmh.php;
http://www.dcbiomed.com/webls-en-us/ReadMyHeart:V2.0.html (version 2); also available from several other online sources. (Note that units offered by some of the other sources may be "locked", not allowing full software functionality without a physician's prescription.)

 

 


 

bd10268_.gif (177 bytes)  REKA E100, https://www.rekahealth.com/. This is a small, round device that uploads directly to the physician via computer or smart phone connections with cloud-based files, records, and communications between the patient and their personal physician. It is available by physician prescription only (although anyone can ask their physician about looking into getting it for them) and involves participation by (and normally originating from) the physician and their medical center. It operates through either finger contacts or optional lead-wire connections and adhesive skin electrodes.

This system is designed for the majority of the public/regular medical patients who know or care little about the intricacies of ECG or dealing with the ECG learning curve or messing with a software on their computer. (If uploading from a computer, the cloud software, once the app is installed, takes care of everything automatically for the patient.) It has no display on the device. One simply picks it up, touches the thumb contacts or connects the electrode wires to adhesive skin contacts, pushes the button to start recording, then uploads the record directly to their own physician for evaluation ... from home, office, or while traveling locally or from anywhere in the world.

For their YouTube introduction to the device, see: http://www.youtube.com/watch?v=PQNK2A61kew&feature=plcp. For other links, see their main page, https://www.rekahealth.com/, and scroll down to the various listed categories and links.


[Description being revised and expanded; photos/figures being added]

 

Device characteristics:

  • Physical:
  • Batteries:
  • Display screen:
  • Length(s) of recordings:
  • Time to auto-shutdown:
  • Additional cable-wires for adhesive skin electrode recording:
  • Internal or memory-card storage capacity:
  • Ability to add comments to recording files:
  • Device menus, options, flexibility, and ease of use:
  • Software or app menus and ease of use:
  • Printouts:
  • Cost:
  • Advanced recordings such as sequential 12-lead:
  • Other aspects and comments:


Source:

 

 


About the Author

James W. Grier is at North Dakota State University, where he has been since 1973. He is currently retired, Emeritus Professor of Biological Sciences. He maintains an office and research lab on campus and stays active in various subjects, including cardiovascular and ECG..

Education:

His interests in biology are very broad, from the molecular to the ecological, particularly in population ecology, anatomy and physiology (particularly cardiovascular and the nervous system), and cover a broad array of organisms, from different groups of invertebrates to vertebrates, including humans. His long-term special interests in particular groups of organisms have included eagles and other birds of prey, fishes, insects, and fossils (particularly ammonites). His teaching background has been similarly diverse, ranging from introductory through upper division, to advanced graduate-level courses with advising of many undergraduate, MS, and PhD students.

As a scientific researcher, he has had long experience doing and teaching about research (including teaching a graduate-level course on biological research for 33 years), across many subjects. Much of that experience and work has involved comparative studies, whether of different animal species and their anatomy/physiology/behavior/ecology or human-made machines and equipment -- the underlying research principles are the same.

Dr. Grier has been involved with the subject of ECGs since 1970 when he took an advanced PhD level physiology course at Cornell University, which included the cardiovascular system, the topic of ECGs, and recording ECGs in lab. He subsequently included the topic of ECGs in his own teaching and when assisting other faculty in human anatomy and physiology, vertebrate and general zoology, and general biology courses since 1973 at North Dakota State University. 

He also has had his own personal heart conditions, a variety of irregular heartbeats or arrhythmias, and since the 1980s, has had numerous trips to the ER, clinic, most of the heart tests available, and two ablation procedures, all of which got him involved with a number of physicians, cardiologists, and electrophysiologists (some of whom had been his previous students) and a much deeper understanding of the subject of ECGs.

Between selecting ECG equipment for use in teaching and research labs and wanting his own personal equipment for monitoring and studying his own conditions, he has been using, reviewing, comparing, and studying ECG machines for many years. Because of his accumulated experience and understanding of the subject and ECG machines, he has been requested to became involved in performance testing, review, including as an expert witness for a court case, and even some research and development efforts for various ECG machines.

He has websites (including this one) on the subject of ECGs, initially developed for students at NDSU but also available to other persons external to NDSU, plus one ECG-related publication with colleagues from NASA and the University of Minnesota:
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0061076.


To contact the author, e-mail: james.grier@ndsu.edu

Author's web page: James W. Grier

Department of Biological Sciences, NDSU

[NDSU home page]        [Site Search]

 


Appendix: Disclosure/transparency regarding potential conflicts of interest

 

Outreach service and helping the public is a part of the three-pronged mission at North Dakota State University: teaching-research-service. Service includes both on- and off-campus, including to the general public, to colleagues and other professional persons and organizations, to local/state/federal/international government agencies and non-government organizations, as well as to industry and business. For most of Dr. Grier's life and entire career, he has been and continues to be a student-teacher-researcher-servant at public universities. His nature is to be open and willing to help anyone.

Dr. Grier is not a physician himself ("not that kind of a doctor"), but he has taught large numbers of physicians and other health care professionals -- including introducing them to cardiovascular topics including ECG. He and several of his relatives and friends have had their own heart conditions, which has made the subject personal and gotten him much deeper into the subject than he taught in introductory university courses. He also served as an expert witness doing ECG research for a legal case.

In the process of using and eventually studying ECG machines, he has gotten experience (since 1970) and obtained ECG machines themselves by a variety of ways. Some equipment was obtained through the years by the university for courses in biology and human anatomy/physiology. Many units he purchased personally, for personal use and research, either directly from ECG equipment companies and distributors or on eBay. Several (full 12-lead) ECG machines and supplies used in the legal case were purchased for his comparative research by the plaintiffs-law firm. Some were donated to him by ECG companies/distributors for the purpose of testing their equipment. And in some cases he has been involved in the development of the equipment and systems, either voluntarily or with reimbursement for time and expertise.

For handheld ECG systems covered in this website, his involvement and obtaining of machines has been as shown below.

Most of the devices were sent to the author after learning of his background and experience, often based on reading this or other of his ECG-related websites. The original three and some of the subsequent ones were sent by Favoriteplus.com to help evaluate the devices for them. Most were sent to Dr. Grier at no cost or reduced cost in exchange for his testing and evaluation. Unless indicated otherwise and when significant amounts of time became involved, he has provided the testing and reporting at no charge to the companies, simply in exchange for being able to try out the devices and new technologies.

Several of the systems have involved feedback and reporting of encountered problems to the companies involved, leading to revisions and their current versions/models and ongoing improvements before the device was reported publicly on this webpage. (Note: Dr. Grier usually find problems with systems! Depending on a company's viewpoint, that might be "dangerous" because he often finds unexpected things they didn't know were lurking in the system ... or it might be good and valuable because he has found several problems before they cropped up to bite the company in the marketplace! Even when there are no problems as such, there are usually opportunities for improvement of a product.)

In return, Dr. Grier wants to express appreciation to ALL of the companies involved for giving him the opportunity to try out and learn about the new products and technologies. It's been a mutual, two-way street, hopefully with benefit also to the readers of this webpage and health care everywhere!

  • AliveCor -- sent to author for testing and reporting at the developer's/company's request.

  • Dimetek Micro Ambulatory ECG Recorder, DiCare-m1CP -- sent to author by the company for testing and reporting at request of Favoriteplus.com for their evaluation purposes.

  • ECG Check -- sent to author for testing and reporting at the company's request.

  • HeartCheck Pen -- sent to author for testing and reporting at the company's request.

  • InstantCheck -- one of the higher-priced devices sent to author at reduced cost by Favoriteplus.com for testing and reporting, for their evaluation purposes, and in exchange for his input and at his request for a more-advanced device at the time. He subsequently purchased more units from Favoriteplus for class/lab use by the university, paid for by the university, plus additional units from other sources for his own uses and paid for personally.

  • MD100E -- purchased outright by the author out of curiosity and following an inquiry from the general public.

  • PC-80 -- sent to author by Favoriteplus.com for testing and reporting, for their evaluation purposes.

  • PC-80B Color -- sent to author by the company for testing and reporting at request of Favoriteplus.com for their evaluation purposes.

  • (printing) ECG/EKG-80A -- purchased outright by the author, based on an inquiry by a reader who was wondering about it.

  • ReadMyHeart -- sent to author by Favoriteplus.com for testing and reporting, for their evaluation purposes.

  • REKA E100 -- (several units) sent to author for testing, reporting, and help with identifying needed improvements at the developer's/company's request, following a visit to Dr. Grier's lab by two of the company's personnel. Dr. Grier spent extensive time with the developers and engineers regarding both the device itself and its cloud-based system, to help correct initial problems and make improvements, for which he received two honoraria and a per diem for a meeting that he participated in, but no salary or contract funding.