Out of Town Heart Patient Uses New Technology For Treatment

Bill McKee of Charleston, West Virginia, knew he had high cholesterol. The 69-year-old financial planner had been taking cholesterol-lowering medication for 25 years. In addition, a stress test years ago indicated he might have heart issues like others in his family. But when he learned at his annual checkup in 2016 that he had atrial fibrillation (AFib), he was stunned.

“Some people can feel their heart fluttering during AFib, but I can’t,” says Bill. “During my appointment, I saw the nurses whispering. Then one asked me if I felt OK. My heart rate was 166 beats per minute.”

Looking back, he remembers getting breathless sometimes when walking the dog or working in the yard.

“I thought I was just getting old,” he says, laughing. “I didn’t suspect AFib.”

Bill’s hometown cardiologist recommended a medication to help regulate heartbeats. But everyone, including the cardiologist, agreed that a visit to Cleveland Clinic should come first.

“I live about a four-hour drive from Cleveland Clinic and knew of others from Charleston going there for specialty care,” says Bill. “I did my own research and saw on the internet that Cleveland Clinic was the best heart hospital in the country.”

“I know doctors are under pressure to see many patients, but Dr. Tarakji told me he had as much time as I needed. We talked until I couldn’t think of any more questions.”

In early summer 2016, Bill made the drive to Cleveland to meet Khaldoun Tarakji, MD, MPH, of Cleveland Clinic’s Tomsich Family Department of Cardiovascular Medicine.

“I know doctors are under pressure to see many patients, but Dr. Tarakji told me he had as much time as I needed,” says Bill. “We talked until I couldn’t think of any more questions.”

Dr. Tarakji scheduled Bill for a hospital stay a few weeks later to help start him on the medication. He also recommended an innovative self-monitoring device, called Kardia Mobile, to help Bill track his episodes of AFib.

Bill bought the small finger pad that connected to his smartphone. By placing two fingers on the pad, he could record his electrocardiogram (ECG or EKG) anytime. Bill would email these recordings to Dr. Tarakji’s office.

AFib is not a one-time episode, explains Dr. Tarakji. It’s a long-term condition, with symptoms that can come and go.

“The smartphone ECG monitor is a convenient way to record what your heart is doing,” says Dr. Tarakji. “Instead of getting one ECG every few months at a doctor’s appointment, you can record ECG rhythm strips regularly. That makes for more meaningful visits with your physician, who can make better treatment decisions based on your heart rhythm over time.”

The smartphone device helped monitor Bill’s condition. The ECGs showed that he was in AFib several times each week — even while taking the medication. The medication wasn’t working.

In February 2017, Bill and Dr. Tarakji met again, this time by video chat using Cleveland Clinic’s virtual visits platform. During their virtual visit, Dr. Tarakji explained that Bill was still having prolonged episodes of AFib at a rapid heart rate. He also explained that Bill would benefit from an ablation procedure to control his AFib and maintain normal rhythm.

Bill returned to Cleveland Clinic for an ablation in April 2017. While there, he learned of a new, secure cloud-based platform customized for Cleveland Clinic that enabled cardiologists to access smartphone ECG recordings without having patients email them. Bill was the first Cleveland Clinic patient to try it.

“After the ablation, I kept recording ECGs every couple of days,” says Bill. “When I met again with Dr. Tarakji four months later, he pulled up all of my ECGs on his computer — the ones I had taken with my smartphone — and confirmed that my AFib was gone.”

“Bill told me he was doing great, but seeing the normal rhythm on each of his smartphone recordings proved it,” says Dr. Tarakji.

While Bill continues to check in with his hometown cardiologist, Dr. Tarakji is only a video chat away. Bill will keep using the smartphone device so ECG recordings are available whenever he has another virtual visit with Dr. Tarakji.

“Virtual visits with the right tools, like the smartphone ECG recording device, can be more valuable than in-person visits without them,” says Dr. Tarakji. “They truly can take the care of our AFib patients to a new level.”