Abstract 19398: Non-Invasive Remote Monitoring of Potassium in Dialysis Patients Using an Internet-Based Wireless ECG Patch
Introduction: Hyperkalemia and hypokalemia are asymptomatic, and may lead to life-threatening arrhythmias. We hypothesized that small changes in potassium lead to subclinical changes in the surface ECG that with individualized modeling and signal processing could permit noninvasive, frequent and near-real time internet based-measurement.
Methods: In this feasibility study, 12 hemodialysis patients underwent 2-4 arterial blood draws to measure potassium during three dialysis sessions and one optional non-dialysis blood draw (10-11 total). Single channel ECG was continuously recorded using the BodyGuardian ECG patch (Preventice, MN, USA). Data were automatically transmitted from the patch to a server, where ECG and accelerometer (body position) data were available for advanced processing (figure). Using the data from the first two dialysis sessions to create an individualized template, the patch data was used to calculate the potassium values during subsequent dialysis sessions based on ECG changes, which were compared to potassium lab values. Additionally, a multi-electrode patch was applied to 4 patients that permitted automated multi-vector selection, to see whether accuracy could be further improved.
Results: Noninvasive potassium values were calculated using a single lead with an absolute error of 0.35 ± 0.28 mmol/L (figure) and 0.2+0.17 using the multi-vector patch compared to lab values.
Conclusions: Using a wearable, wireless, secure internet-enable ECG patch and advanced signal processing, it is feasible to remotely calculate potassium with an error less than 8% compared with blood testing. The error is reduced to 5% using a multi electrode patch. If further developed and validated, this could have important implications for remote patient management and drug titration.
Author Disclosures: Z.I. Attia: None. J.J. Dillon: None. C.V. DeSimone: None. Y. Sapir: None. V.K. Somers: None. J.L. Dugan: None. M.J. Ackerman: None. S.J. Asirvatham: None. J. Bukartyk: None. C.G. Scott: None. D.J. Ladewig: None. G.J. Seifert: None. P. Gibson: None. A. Geva: None. D. Sadot: None. P.A. Friedman: None.
- © 2016 by American Heart Association, Inc.