Doctor Column

A 53 year old woman was examined by a Cardiologist and diagnosed as having atrial fibrillation (irregular heart rhythm). The episodes increased in frequency and duration causing shortness of breath, fatigue, and at times lightheadedness and dizziness. She eventually had a small (the size of a finger nail) cardiac loop recorder implanted just under the skin into the left side her chest. When she experiences an episode, she presses a button, and places the Medtronic device against the left side of her chest. A cardiogram is recorded and transmitted to her Cardiologist for evaluation.

Palpitations, and elevated heart rate are symptoms that nearly everyone experiences at some point in their life. Most often, “skipped beats” or the perceived irregularity in cardiac rhythm is benign and may be the result of stress, poor sleep patterns or even increased consumption of dietary stimulatants (e.g. Caffeinated beverages, alcohol even in modest amounts). With increased age however, this may also represent a potentially very serious rhythm disorder known as atrial fibrillation.

Telemedicine appears to be particularly well suited for the management of diabetes. Given the growth of diabetes in the population and an increasing shortage of Endocrinologists, patients with diabetes often face long delays in medical care. Travel distances may be hundreds of miles and wait times for appointments can be several months duration. For those with more advanced illness or age, these obstacles may be insurmountable. Even in urban areas with more specialists, traditional doctor visits require a significant time commitment and time off work.