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Community Medicine Rants - MacGyver’s Heart Monitor

Al Sacchetti, MD and Joshua Rudner, DO
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06:20
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Nurses Edition Commentary

Lisa Chavez, RN and Kathy Garvin, RN
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00:35

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EM:RAP 2017 September Written Summary 760 KB - PDF

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Rabbott -

For cyclists (and some runners), the online site Strava.com serves as social media for sharing heart rate, power, speed, and location data. It can be quite informative (OK, just fun) to review Strava heartrate files (they are public) of friends and acquaintances who have had aortic dissections, implanted defibrillator firings, bouts of A Fib, and VF arrests (I was the bystander CPR for the guy following my wheel in a bicycle race when he arrested - he did fine. My heart rate response was at least as interesting as the victim's). Proofreading this, I wonder why I have so many friends who have "interesting" heart rate files????

Ritter -

Does anyone else have an issue with depending on heart rate alone to decide when a patient went into A-fib? The patient in this scenario could have been in rate controlled A-fib for days/weeks without going into RVR. Just because their heart rate jumped from a normal rate to tachycardia does not mean they went from NSR to A-fib with RVR. They could have gone from rate controlled A-fib to A-fib with RVR, thus making cardioversion contraindicated.

Alfred S., M.D. -

I think you need to look at the entire clinical picture. If they were rate controlled prior there would be no reason to become uncontrolled and remain uncontrolled. The seizure could give a transient elevation in rate but it would return to normal within a few hours.

Alfred S., M.D. -

I think this is only the beginning of what we will see these devices being used for in the future.

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