title: Using a novel wireless system for monitoring patients after the atrial fibrillation ablation procedure: the iTransmit study.
abstract: BACKGROUND
  A novel technology incorporates electrodes into an iPhone case that records an electrocardiographic tracing.
  
  
  OBJECTIVE
  The objectives of this study were to examine the feasibility and efficacy of this technology to monitor patients after the atrial fibrillation (AF) ablation procedure and to assess patients' feedback on its ease of use.
  
  
  METHODS
  Patients with AF undergoing ablation who had iPhones were screened for enrollment. They were provided with an AliveCor heart monitor (AHM) case and a traditional transtelephonic monitor (TTM). Patients were asked to record their rhythm using both monitors simultaneously whenever they had symptoms or at least once a week. AHM recordings were sent to a secure e-mail account, and TTM recordings were transmitted to our Holter laboratory using landlines. All AHM recordings were reviewed by 1 of 2 blinded electrophysiologists. TTM recordings were reviewed by the primary electrophysiologist. The κ coefficient was calculated to assess agreement between AHM and TTM recordings. Sensitivity and specificity for the detection of AF and atrial flutter with the AHM compared to the TTM were calculated.
  
  
  RESULTS
  Sixty patients were enrolled (mean age 60 ± 12 years), and 55 completed the study. There were 389 simultaneous AHM and TTM recordings. The κ statistic was 0.82, indicating excellent agreement between AHM and TTM recordings. If we consider AF and atrial flutter as one diseased state, the AHM had 100% sensitivity and 97% specificity for the detection of AF and atrial flutter. Only 2% of patients found it difficult to use the AHM, and the large majority (92%) preferred to use the AHM to monitor their AF as opposed to the TTM.
  
  
  CONCLUSIONS
  The AHM is an alternative method for monitoring patients with AF after the ablation procedure. Most patients found it easy to use.
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: tarakjk@ccf.org.
authors.forename: Khaldoun G
authors.initials: KG
authors.lastname: Tarakji
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Oussama M
authors.initials: OM
authors.lastname: Wazni
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Thomas
authors.initials: T
authors.lastname: Callahan
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Kanj
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Ali H
authors.initials: AH
authors.lastname: Hakim
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Kathy
authors.initials: K
authors.lastname: Wolski
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Wilkoff
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Walid
authors.initials: W
authors.lastname: Saliba
authors.affiliation: Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Lindsay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D040421:Cell Phone / Q000295:instrumentation*; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D012680:Sensitivity and Specificity
keywords: Ablation; Atrial fibrillation; Monitoring; Smartphone