Review: WIWE, a business-card sized clinical-grade ECG monitor
Heart disease is a major cause of death for both men and women. In the US it leads to more than 600,000 deaths each year–that’s 1 in every 4 deaths.
An ECG is often used by doctors to help diagnose and monitor conditions affecting the heart. It shows its electrical activity as a moving line of peaks and dips. This info can be used to identify potentially dangerous conditions such as arrhythmias, heart defects, heat inflammation, cardiac arrest, poor blood supply, coronary artery disease and more.
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These are still very early days for wearable ECGs but the industry is growing rapidly. Apple took a major step forward to influence the future of healthcare with its ECG enabled Series 4 watch last year. Withings is set to deliver a ECG activity watch and blood pressure monitor later in 2019. But there are other options out there.
One of these comes from Sanatmetal, a Hungarian owned outfit which has been serving innovative devices and implants to clinicians since 1967. I’ve had a chance to test WIWE, their portable ECG monitor. The company says it dishes out clinical-quality results after 1 minute. Here’s what I made of it.
WIWE is very portable and lightweight. The size of a business card but slightly thicker, it can fit easily into your pocket or bag. You might even manage to slip it into your wallet!
The device has a single physical button along the top right edge which is used to power it on and off. The bottom right edge is where the charging cable plugs in. The other end of the charging cable goes into a standard USB port.
Switch WIWE on and you’ll notice two sets of lights. The first is a string of 5 small LEDs which shows the current battery level. The other is a large W-shaped light which sits between the electrodes. This is used as a progress bar to show how much time is left to complete a measurement and whether the reading was successful.
ECG monitors work by making contact with the skin and WIWE is no different. It has two electrodes, each the size of a dime. When taking a reading, you are meant to place your thumbs or index fingers on each of them and sit still until the measurement is complete.
The device is used to record single-channel electrocardiogram (ECG). It needs 60 seconds to spit out clinical-grade information about your heart rhythm and possible deviation from the normal. Accuracy is what distinguishes WIWE from other such devices.
In clinical trials, its algorithm has achieved 98.7% ECG accuracy when tested against 10,000 samples . WIWE can detect the risk of both afib-stroke and sudden cardiac arrest. And it has the EU regulatory body’s approval to do this (CE mark in medical device category).
The left electrode also has an SpO2 sensor baked in which is used to measure blood oxygen levels. There’s even an accelerometer inside if you wish to use the thing as a pedometer. This is for those that don’t already own a fitness tracker or smartwatch, and don’t wish to use their smartphone to count steps.
Setting up WIWE is simple. You’ll need an iOS or Android smartphone or tablet. Download the accompanying app, enter your details and let it pair via Bluetooth to WIWE. The whole process worked flawlessly for me and took only a few minutes. You have the option of taking recordings anonymously, too.
Operating the device is just as easy. Open up the smartphone app and navigate to the dashboard. You’ll be presented with four choices, New recording, Profile, Information and Settings. The first of these takes you through to the Bluetooth pairing screen. Switch WIWE on and the app will transition to a pre-recording screen.
Now rest your thumbs against the two sensors with your index fingers holding the back of the device and none of your other fingers touching. The alternative is to place WIWE on a flat surface and press the electrodes with your index fingers. I typically found myself opting for the first of these two options.
You’ll need to hold this position for about 10 seconds until the app confirms that you’re holding WIWE correctly. If not it will ask you to readjust. If everything is ok, it will progress to the reading. This is when you’ll start to see your ECG curve on the app display in real-time as a scrolling line of peaks and troughs. In the top right-hand corner you’ll also notice your pulse changing and next to it your SpO2 level. As mentioned, the measurement needs 60 seconds to complete.
Let go of the sensors when asked to do so and the app will take you through to the evaluation screen. This is where you’ll get immediate feedback on the data collected.
In plain English the app will explain whether your ECG parameters are within the normal range, whether there are any signs of arrhythmia and whether the ventricular depolarisation heterogeneity (electrical instability of cardiac muscle cells) is normal.
Each category appears in a green, yellow or red circle so you’ll be able to tell at a glance if there’s anything to be concerned about. I must have done more than 30 readings over the past week and my results were typically in the normal range. I did get a few yellow circles (a small deviation) in my VH levels. Nothing to be concerned about but worth keeping an eye on.
The evaluation screen also shows your SpO2 level and heart rate. My SpO2 level ranged between 96% and 99% and heart rate was usually in the 50s.
If you click on the ‘details’ tab, you’ll be taken through to very detailed analysis of your ECG parameters, including QRS, QTc and PQ. I suspect this part of the analysis will be more interesting to your doctor or cardiologist as the average person may struggle to understand the medical terms despite the help screen’s lengthy explanations.
Here you can also review the entire ECG recording. Each measurement uses about 700 kB, and a person can select how much storage to allot to these recordings in the settings screen.Users also have the option to add commentary to each measurement such as symptoms, whether pills were taken and more. If they choose to do so, they can then send the recording to their loved ones or a medical professional in the form of a PDF or email.
Here’s a video I made of just how easy it is to take a reading.
The Hungarian outfit suggests you take recordings 3 times per week. If your results are out of whack or you experience symptoms such as fast heart beating, fluttering in the chest or shortness of breath, you should do this more often and consult with your doctor.
The app also provides a Health journal. This shows a timeline of all your readings. You can click on any measurement to access all its detailed data.
Now you may be asking yourself if there is any difference between WIWE other ECG wearables on the market such as the Apple Watch Series 4 and Alivecor. All three of these are one-lead ECGs and check for atrial fibrillation, but that’s pretty much where the similarity ends.
WIWE goes further in that it does a more comprehensive ECG wave analysis and offers results with 98.7% accuracy. It looks for irregularities in the ventricular department and not only in the atrial activities, so can give a warning if there are early signs that could lead to sudden cardiac arrest. Even a-fib detection is done with more precision. WIWE also examines the “P” wave of your measurements allowing it to dish out ECG specific parameters such as QRS, QTc, PQ. These can be useful to clinicians as well as the well informed layman.
Finally, while the Apple Watch Series 4 may offer more convenience in that you are wearing it most of the time, the ergonomic configuration of WIWE is more conducive to obtaining accurate measurements. Keeping your thumbs or index fingers on electrodes of a device that can be placed on a flat surface or held in both your hands will dish out more reliable results than resting your finger against a watch sitting on your wrist.
Santametal is not stopping here and there is more functionality to come in the future. The outfit is working closely with Harvard medical university in the US on a project that will connect WIWE to a cloud system for remote monitoring. The idea is to use this to predict heart attacks a few days before they happen.
In the last few weeks, Pfizer Pharmaceutical and the Hungarian Society of Cardiology sponsored 160 pieces of WIWE devices for cardiology centres to detect dangerous arrhythmias, such as atrial fibrillation. 60 of these are already in use with the other 100 to be used in a few months time.
WIWE offers you a simple and convenient way to stay on top of your heart health. It goes further than most other such devices on the market in that it offers more detailed analysis of your ECG including irregularities in the ventricular department and not only in the atrial activities. And it does this with 98.7% accuracy.
This allows you to monitor for potential arrhythmias and risks of stroke and sudden cardiac arrest risk from the comfort of your home. It may give you an early warning that a consultation with your doctor is needed. There are also some extras such as SpO2 measurements and the ability to count steps.
All in all I found WIWE worked as advertised. I suspect most people are unlikely to buy this on a whim as it sells for €289 on mywiwe.com. But if you have reason to be concerned about your heart health or already have a diagnosed condition, it may end up being a life-saving investment.
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