ECG Innovation Brings A New Age To The Segment

The ECG industry is booming with innovative products and research and development activities.

Technology has made its way into the healthcare sector and brought a drastic transformation. Detection of heart conditions that was not possible before has become possible. With surge in heart conditions across the world, it is essential to detect them as soon as possible. Innovative methods and devices have been developed for prolonging and saving lives of people through detection of heart conditions.

Electrocardiograph (ECG) readings taken through devices for detection of atrial fibrillation would offer ease in use to users and would prove to be a crucial factor in saving lives. The ECG industry is booming with innovative products and research and development activities.

Apple watch ECG monitoring. Apple watch in synchronization with an ECG app has been able to detect an undiagnosed heart condition. The ECG feature is now included in the Apple watch. It is intended to determine the heart conditions that do not show obvious symptoms. Recently, the device in sync with an app was able to help a man in Germany detect a serious heart condition. There was an ECG function for hypochondriacs and the user tried this feature when released for watchOS 5.2.

The tech giant released an update that enables ECG hardware on Series 4 units. The user outlined that there were multiple readings showing the signs of atrial fibrillation (AFib), which went undetected by physicians. The user was not able to determine whether the device was offering an accurate reading. So, he showed it to his physician. After checking the readings, physician stated that the watch was right. Then, beta blocker prescriptions were provided for AFib diagnosis. The man admitted that the Apple watch helped in prolonging his life.

New, innovative methods to record ECGs. An innovative ECG method that involves using signals from ears to check rhythm of the heart has been developed by researchers. This method would help drivers, military personnel, and athletes to track their own heart conditions. Researchers outlined that mobile ECG devices offer a lot of opportunities for detection of atrial fibrillation, which is the most common heart condition. These devices help in prevention of strokes and lower hospitalizations. This is the first research in which an ear has been used for detection of ECG signal, outlined researchers present at the annual congress of European Heart Rhythm Association 2019 in Lisbon.

The study had 32 volunteers participate. An ECG was carried out using a standard method, in which the middle finger and the index finger of each hand were used. Then a second ECG was carried out with the help of middle and index finger of left hand and a clip to left ear. Two cardiologists, who were not informed about which method represents the results, analyzed the results obtained by both methods. The researchers outlined that there were no differences in the ECG results gained from both methods.

Increasing incidences of cardiovascular diseases and lifestyle-associated diseases as ischemic heart disease (IHD), hypertensive heart disease, stroke, and peripheral artery diseases are anticipated to drive diagnostic electrocardiograph market in coming years. Increasing geriatric population base, improving healthcare infrastructure, and supportive reimbursement policies are expected to drive the global diagnostic ECG market. Furthermore, continuous advancement in technologies for ECG devices, coupled with introduction of remote monitoring devices, is expected to fuel the growth of this market over the next 6 years. Developing nations witness high growth opportunity in comparison with developed countries owing to the fact that the market of developed nations is almost saturated. Additionally, developing nations are expected to witness lucrative growth opportunity owing to favorable government policies, increasing expenditure in healthcare, and large untapped potential market.

The global ECG equipment market was valued at USD 4.13 billion in 2018 and is expected to generate around USD 6.25 billion by 2025, at a CAGR of around 6.2 percent between 2019 and 2025, predicts Zion Market Research.

The Holter ECG monitors are expected to witness a significant growth rate during 2019–2025. The Holter ECG monitors were considered as the most common type of ambulatory monitoring of ECG, which has led to their high utilization. The introduction of wireless Holter monitors helped enhance its share.

The penetration of wireless systems in point of care boosted the adoption of homecare setting, which further propelled the growth of the global ECG market.

The ECG equipment market in North America is expected to hold the largest share by 2025 as the possibilities of the rising number of lifestyle-oriented diseases, increased spending rate for healthcare, and technological advancement in cardiology segment could drive the market ahead. There has been an increase in pressure for hospitals to become paperless to curb costs as a result of healthcare reforms. Hence, the use of ECG devices that can be connected to the integrated data management systems of hospitals, or the use of electronic medical records to maintain patient databases, has increased in the recent past. On the other hand, the Asia-Pacific market is anticipated to be the fastest-growing region for the ECG equipment market, and is expected to exhibit substantial growth in this market during 2019–2025.

Indian market dynamics
The Indian ECG equipment market in 2018 is estimated at Rs 268.48 crore. In value terms, the high-end machines account for a 60 percent share, albeit only a 26 percent share by volume. By volume, the 3-channel systems lead the market, contributing 34 percent to the market. In spite of declining demand, the single-channel ECG equipment continues to have a stronghold in the market, with a 5.2 percent share, by value. This is in contrast to the global scenario, where the 3-channel and single-channel ECG devices have almost exited the market, with the upcoming trend of CCAA (culprit coronary artery algorithm), promising to predict where exactly the block is located in the coronary artery in case of heart attack or chest pain.

In the high-end ECG segment, the 12-channel ECG machines contribute 72 percent, by value and 84 percent, by volume. The low-end stress ECG machines are also popular with an 11 percent share, by value and 8 percent share, by volume. The low-end Holter, the high-end Holter, and the high-end, stress-test ECG machines, each have a market share in the vicinity of 5 percent, by valueIn 2018, whereas ECG machines from Philips and GE continued to be sold, combined with other equipment as packages, primarily for ICUs; Schiller and BPL gained ground through the retail segment. Mindray continued to find success in tenders invited by the government’s medical facilities.

The blind spots in remote cardiac monitoring
Until recently, cardiologists trying to diagnose and treat arrhythmias have had to deal with technological limitations in data transmission, storage, and analysis. They had to rely on third-party independent diagnostic and testing facilities (IDTFs) to read remote cardiac monitoring data and then phone, fax, or e-mail the important events back to the practice.

Ninety-five percent or more of the data gets lost in transmission. IDTFs may catch an arrhythmia during the monitoring period, and send the physician a short 20- or 30-second strip. But too often, the cardiologist never sees the critical onset and offset data in the minutes immediately prior to and after the arrhythmia.

Legacy ambulatory monitoring companies only provide patient-triggered or algorithm-triggered events for evaluation by the physician. This accounts for far less than 5 percent of the recorded data. Physicians have no easy way to verify the accuracy of the data or gauge what might be missing.

The data loss can be immense. Many vendors claimed to offer full disclosure, but still only transmitted a few glimpses, measurable in seconds, of the patient’s cardiac data to the doctor. Verification can be difficult, or in some cases impossible, and if a doctor has questions, they need to spend time calling the IDTF call center, get transferred around, and explain their question and wait for the IDTF technician to access any data they have.

The process is slow and expensive, and results in massive blind spots for the care provider trying to diagnose and treat the cardiac patient.

Even when an IDTF captures critical data, the process of actually getting the information in front of the physician for diagnosis and intervention can take hours and even days. In practice, the patient could potentially have a rhythm abnormality on a Holter that the physician and the patient are not aware of for another week.

More than half of all clinically significant arrhythmias are reported after a typical two-day Holter monitoring period is over. Devices that rely on self-activation usually miss the critical first few minutes of onset data. Additionally, one in four patients is unable to activate the device during a cardiac event.

If an undiscovered dangerous arrhythmia is detected, this inefficient process leaves the patient vulnerable. Eliminating these delays can avert syncopal episodes and potentially sudden cardiac death (SCD).

New technology in the field today can help streamline the process, and quickly eliminate the need for these costly IDTF intermediaries.

Recent advances in HIPAA-compliant telecommunication and data analytics now enable secure transmission of full-disclosure, telemetry-like data throughout the monitoring period, in near real-time, directly to the physician’s tablet or smartphone. Exciting new technological developments are bringing rapid improvements to remote cardiac monitoring. These include next-generation remote cardiac monitoring devices that use deep-learning and software as a service (SaaS) remote cardiac-monitoring platforms. These newer monitors and accompanying software can help realize the elusive promise of remote cardiac monitoring platforms.

The newly emerging ability to transmit full-disclosure data throughout an extended monitoring period directly to the physician’s mobile device, and enable early access to the data during the monitoring period, is game-changing and promises to disrupt the cardiac monitoring industry.