To treat arrhythmias, the prerequisite is to detect abnormal heart rhythms. The dangers of asymptomatic atrial fibrillation have been discussed in previous issues, and how to detect abnormalities in various heart rhythms, including atrial fibrillation, using various tests is the focus of this issue. For the examination of heart rhythm, the first thing most people think of is ECG, which is the easiest and fastest way to diagnose atrial fibrillation. When a patient has panic attacks and chest tightness, an ordinary 12-lead ECG can clearly lead to the diagnosis of atrial fibrillation. However, as mentioned in the previous article, the scary thing about asymptomatic atrial fibrillation is that the patient has no conscious symptoms and is often missed because the patient is not having an episode of atrial fibrillation at the time of the test, so a longer ECG, or “holter” as doctors call it, is required. The Holter is actually a small ECG machine with a different number of leads and connections than a regular ECG for the convenience and comfort of the patient. From the point of view of data analysis, because the recording of leads, holter examination results are often the most comprehensive, but its disadvantages are also obvious, every day with a small box, will be examined by the daily activities and night sleep caused by a great impact, some patients with sensitive skin, but also because of a long time patch allergy and suffering. And many of the arrhythmias, including atrial fibrillation, are like well-hidden criminals, only once every few days or even months, even the Holter test can not be detected. Now for this kind of infrequent heart rhythm abnormalities, doctors also have a solution, you are just a long latency, then I will 24 * 7 hours * 31 days * 12 months to spend with you, one day the heart rhythm abnormalities will reveal their horses. The small USB flash drive-like device below is called “implantable ECG event monitoring device”, which is only half a knuckle in size, we make a small opening in the patient’s chest and bury it under the skin, its built-in battery can continuously record up to three years of ECG information. Once a patient has a panic attack, syncope, or other suspected abnormal heart rhythm, we can read and analyze the data with a special programmable instrument to obtain valuable diagnostic evidence. Many pacemakers have a heart rate recording and analysis function, so such patients who have been implanted with pacemakers can record the approximate time of occurrence themselves once an abnormal heart rate event occurs, and come to the pacemaker clinic to program the pacemaker, and may be able to find valuable information about the arrhythmia, and among the arrhythmias recorded by these pacemakers, the one we observe the most is atrial fibrillation. All of these tests are performed in hospitals, led by physicians, but is there a way to detect heart rhythm abnormalities at the patient’s home? With the advancement of electronic technology and the development of smart hardware, this has become a reality. The picture above is the back of a smartphone, the small mouth below the camera is the phone’s built-in heart rate detection sensor, in fact, after installing certain software, it can not only measure the speed of the heart rate, and can even determine whether the heart rhythm is neat. This picture below is a big brand sports bracelet, this kind of wearable device in the statistics of sports, monitoring the role of sleep general wearers are already familiar with, in fact, the new generation of bracelets are also integrated with the heart rate monitoring window, and smart phones, compared with the advantages of continuous monitoring records. This picture is an electronic blood pressure monitor, we all know that even 100 yuan electronic blood pressure monitor are integrated with the function of heart rate display, and this blood pressure monitor is more high-end, able to count the rhythm of the patient’s heartbeat, if the analysis after monitoring a few seconds found that the patient’s heart rate is absolutely uneven, that is, atrial fibrillation hair, it can remind the measurer in a striking way. Although it is convenient to record at home, there are also disadvantages, what if you can’t read what is recorded? If atrial fibrillation is really detected, do not you have to go to the hospital to consult a doctor? This has given rise to the heart rhythm cloud platform that connects patients with our doctors. There are several models of patient side of this platform, one is a special smartphone with ECG sensing electrodes on the back (above), when the patient feels uncomfortable, the back of the phone can record the ECG signal by sticking it to a specific location on the chest as required; the second is combined with a wearable device, this ECG sensing device is made into The second is combined with a wearable device, this ECG sensing device is made to look like a chest strap, as there is no need to paste electrode patches, better comfort, patients can wear it continuously for a longer period of time, once atrial fibrillation and other arrhythmias are detected, in addition to alerting the patient, at the same time can automatically send data to a special processing center, if the heart rhythm has serious problems, the doctor will take the initiative to contact the patient for medical consultation or guidance for emergency treatment. Such a cloud-based monitoring device use and management model has been in operation for more than 3 years in the cardiac arrhythmia and atrial fibrillation clinic of Ningbo First Hospital, and has promptly detected and treated many patients with asymptomatic arrhythmias in the community. Advances in technology not only bring more comfort to life, but also give more means to maintain a healthy heartbeat.