Implementation of AliveCor KardiaMobile electrocardiogram (ECG) 6-lead in an early intervention psychosis (EIP) service: a mixed-methods evaluation of completed ECGs outcomes and feedback from patients and staff

Abstract

Background: Clinical guidance recommends that people with psychotic disorders are assessed for cardiovascular issues at least annually, at the start of antipsychotic medication and following medication changes such as dose changes and switching of antipsychotic medication. The AliveCor KardiaMobile 6-lead electrocardiogram (ECG) is a small, battery operated, hand-held portable ECG which has comparable accuracy to a 12-lead device and may be suitable, in particular for QTc monitoring, where it is not practical or preferable to use a 12-lead device. Purpose/Aim: To obtain patient and staff feedback on KardiaMobile and to quantify ECG completions within an early intervention in psychosis (EIP) service. Methods: A mixed-methods evaluation was undertaken, using patient and staff surveys, alongside data collection and analysis to report ECG completion. Results: The use of the KardiaMobile 6-lead in EIP was associated with improved ECG completion rates, enhanced compliance with antipsychotic monitoring guidance, and reduced patient refusal. Patient and staff feedback indicated that the KardiaMobile 6-lead was portable, accessible, easy and simple to use and was quicker, less intrusive, and more efficient than a standard 12-lead device. Conclusion: The findings support use of KardiaMobile 6-lead for better healthcare guidance compliance, safer prescribing, and better patient outcomes. By addressing the practical, emotional, and cultural barriers often associated with traditional portable ECGs, KardiaMobile fosters greater patient engagement and staff efficiency. A 12-lead device may be required in some cases and should be obtained at baseline if possible as it provides more comprehensive information and rules out pre-existing abnormalities, it is also indicated in specific clinical guidance. The addition of the KardiaMobile 6-lead offers flexibility and enhanced compliance with guidelines. It is essential that heart functioning assessment is undertaken to maximise compliance with guidelines, safety, and best patient outcomes, and that appropriate ECG assessment remains a priority of mental health services.