The Feasibility Of ECG Monitoring For Members In Arizona Tribes - A Healthy Lifestyle Pilot Project

For American Indian and Alaska Natives (AI/AN) living in Arizona, cardiovascular disease (CVD) is a primary cause of death. Moreover, since many older AI/AN individuals live remotely, they may lack timely medical feedback and intervention associated with a cardiac emergency. PURPOSE: Our aim was to assess the feasibility of wearing a portable electrocardiogram (ECG) device over a 14-day period in a local and remote-living AI/AN population. METHODS: AI/AN participants (n = 10) from Northern Arizona were enrolled. The BodyGuardian Mini (Boston Scientific, Boston, MA), a Holter monitor device—worn 24/7—over a 14-day timeframe, was utilized. Participant baseline and follow-up interactions included: (1) signed informed consent, (2) learned about the daily care and skin prep associated with the device placed over the sternum via an adhesive strip, (3) obtained demographic and self-reported health history information, (4) created participant accounts through the Boston Scientific portal system, (5) administered a post-monitor survey related to the wearability and comfort of the monitor, and (6) delivered diagnostic reports within 1-2 weeks post-monitor. RESULTS: Age (yrs), height (cm), weight (kg), resting heart rate (bpm), systolic blood + diastolic resting blood pressure (mmHg), waist to hip ratio, gender, and tribal affiliation were, respectively (mean ± SD): 47.2 ± 13.8, 165.6 ± 4.3, 88.7 ± 15.5, 76.8 ± 11.3, 120.6 ± 9.0, 77.4 ± 4.4, 109.0 ± 12.5, 1.0 ± 0.05, 8 female/2 male, 8 Navajo +1 Cheyenne/Arapaho +1 Utu Utu Gwaitu Benton Paiute/Kiowa. On a scale of 1 (worst) to 5 (best), participants rated the device’s overall wearability and every-day comfort a 4.0 ± 0.5 (mean ± SD), with an average range of 3.8 - 4.5. A cardiology group from Boston Scientific analyzed the ECG data and produced a diagnostic report. All participants had <1% PACs and PVCs, no atrial fibrillation, and no adverse CVD events. CONCLUSIONS: Participants had a positive viewpoint of wearing the device with minor skin irritation and limited interruption of daily life. The device could be smaller with a more efficient way to record signs and symptoms. Future studies should include a similar ECG monitoring device that is coupled with a home exercise intervention in remote-living AI/AN population at risk for or diagnosed with CVD.