An Evaluation of the Safety and Clinical Utility of Handheld ECG Technology in Psychiatry

Study Overview
=================
Brief Summary
-----------------
Acetylcholinesterase inhibitors and antipsychotics are drugs commonly prescribed in psychiatry, the former for dementia and the latter for acute and chronic psychotic illness. Both can cause cardiac arrhythmia therefore 12 lead ECG's are recommended before prescribing. The test is often difficult to obtain however, leading to either patients being inconvenienced or drugs prescribed without the test. There are two parts of this study, but both examine the utility of single lead ecg monitoring, one in the memory clinic and the other in inpatient psychiatry wards. The aim to to evaluate the safety and efficacy of the handheld ecg versus the 12 lead and 6 lead ecg, and whether the handheld ecg can be used to screen for ecg abnormalities that would generally lead to a caution or contra-indication for acetylcholinesterase inhibitors and anti-psychotic medication. Patients will either be recruited from the outpatient memory clinic or in patient psychiatry wards. Following informed consent baseline demographic data will be collected, and patients will undergo a 12 lead and 6 lead ECG as well as a rhythm strip using the handheld device. Data from this point will be annonymised for future analysis. The psychiatrists ECG report will also be recorded, and a subset of patients will undergo an echocardiogram (to see what proportion of patients with psychiatric disorders have structural heart disease.)

Official Title
-----------------
An Evaluation of the Safety and Clinical Utility of Handheld ECG Technology in Psychiatry

Conditions
-----------------
Cardiovascular Diseases, Dementia, Mental Health Disorder

Intervention / Treatment
-----------------
* Device: 12 lead ECG monitoring
* Device: 6 lead ECG monitoring
* Device: Hand held ECG monitoring


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Any patient attending the memory clinic Any patient admitted to the acute psychiatric ward requiring antipsychotic medication Exclusion Criteria: Patients who lack capacity and do not have a personal consultee to provide assent

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Mental Health<br> | Device: 12 lead ECG monitoring<br>* Rate, Rhythm, QTc and PR interval will be assessed<br>Device: 6 lead ECG monitoring<br>* Rate, Rhythm, QTc and PR interval will be assessed<br>Device: Hand held ECG monitoring<br>* Handheld ECG machines are portable, inexpensive, hand held devices that provide a 'real-time' rhythm strip, equivalent to lead I or II on a 12 lead machine, depending on how the device is held. The rhythm strip is displayed on a computer tablet or mobile phone, and are compatible with both android and iPhone platforms. To perform the test the patient places their fingers/thigh, or alternatively the device can be placed directly on the patient's chest. The process does not require the patient to be exposed, can be done in a seated position (negating the need an examination couch) and their ease of use and portability means they could be readily used in memory clinics or community settings.<br>* Other names: AliveCor ECG device;|
| Psychiatric<br> | Device: 12 lead ECG monitoring<br>* Rate, Rhythm, QTc and PR interval will be assessed<br>Device: 6 lead ECG monitoring<br>* Rate, Rhythm, QTc and PR interval will be assessed<br>Device: Hand held ECG monitoring<br>* Handheld ECG machines are portable, inexpensive, hand held devices that provide a 'real-time' rhythm strip, equivalent to lead I or II on a 12 lead machine, depending on how the device is held. The rhythm strip is displayed on a computer tablet or mobile phone, and are compatible with both android and iPhone platforms. To perform the test the patient places their fingers/thigh, or alternatively the device can be placed directly on the patient's chest. The process does not require the patient to be exposed, can be done in a seated position (negating the need an examination couch) and their ease of use and portability means they could be readily used in memory clinics or community settings.<br>* Other names: AliveCor ECG device;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ECG monitoring | 12 lead, 6 lead and handheld ECG device monitoring will be undertaken. | 45 minutes |