P0033 - Use of AliveCor Kardia Mobile in the Detection of Supraventricular Tachycardia in a Pediatric Population

Introduction: Companies such as AliveCor have developed devices to capture cardiac rhythms and transmit the one-lead rhythm strips to smart phones. These devices have typically been marketed for the detection of atrial fibrillation in adults. However, there is the potential for use in the pediatric population. Supraventricular tachycardia (SVT) is the most common dysrhythmia in children.

Case Description: A patient initially presented at 13 years-old due to palpitations. Over the next 2 years, she underwent 3 ECGs, a Holter monitor, a 30-day event monitor, and exercise stress testing with no arrhythmias captured. The patient subsequently bought an AliveCor Kardia Mobile device that captured a 20-minute episode of SVT with documented retrograde p waves at a heart rate of 230-250 beats per minute (Figure 1). An EP study was subsequently performed and revealed easily inducible orthodromic reciprocating tachycardia utilizing a left lateral concealed accessory pathway (Figure 2). The patient subsequently underwent successful radiofrequency ablation of the accessory pathway. Greater than 1 year post ablation the patient has had no recurrence of SVT.

Discussion: This is a case of SVT that was unable to be documented by traditional studies, including Holter and 30-day event monitors. The AliveCor Kardia Mobile device was able to document the infrequent tachycardia and showed findings which helped delineate the specific type of SVT. Mobile ECG devices are a potential option to capture arrhythmias in the pediatric population, especially those infrequent episodes that are more difficult to capture through traditional methods. As companies develop multi-lead devices and other advancements, personal ECG devices will be more accurate and may become a more integral component of arrhythmia evaluation.

Conclusion: Mobile ECG devices, such as AliveCor Kardia Mobile, should be evaluated for validity and accuracy as an additional modality in the diagnosis of pediatric arrhythmias.