After some evaluation of evidence, NICE now recommend the KardioMobile device for recording of arrhythmias, and in some areas this has replaced the standard 24/48 hour recorder.
https://giftshop.bhf.org.uk/alivecor-kardiamobile-ecg-monitor
NICE link https://www.nice.org.uk/guidance/mtg64/chapter/1-Recommendations
If you were going to spend some money, you could consider getting one of these devices and recording when symptomatic (needs a smart phone) then present the findings to GP.
Snip of the evidence summary from NICE:
3.2
Of the 27 included studies, 16 studies were peer reviewed, including 4 UK studies (Bray et al. 2021, Dimarco et al. 2018, Reed et al. 2021, Reed et al. 2019), one of which is an RCT (Reed et al. 2019). The included studies covered 6 population groups:
people with palpitations
people with a history of atrial fibrillation (AF), who have had treatment (ablation, cardioversion, or medical therapy) to restore sinus rhythm and used KardiaMobile to identify recurrence
people with diagnosed AF to assess AF burden
people with transient AF after surgery or hospitalisation whose heart rhythms reverted back to sinus rhythm before discharge and used KardiaMobile to identify recurrence
people after stroke or transient ischaemic attack who were monitored using KardiaMobile
mixed population including people with known or suspected AF.
All published evidence is on the single-lead KardiaMobile device. For full details of the clinical evidence, see section 4 of the assessment report in the supporting documentation.
Evidence shows that monitoring with KardiaMobile increases AF detection
3.3
Three RCTs including 1 UK trial (Goldenthal et al. 2019, Koh et al. 2021, Reed et al. 2019) found that significantly more people in the KardiaMobile monitored group had AF detected compared with those who had standard care, which included 24‑hour Holter monitoring. This was supported by the results from an observational study (Yan et al. 2020).
Evidence suggests that the KardiaMobile algorithm has a high diagnostic accuracy per electrocardiogram (ECG) recording
3.4
Four peer reviewed studies (Hermans et al. 2021, Lowres et al. 2016, Selder et al. 2019, William et al. 2018) reported on the diagnostic accuracy of AF detection using the KardiaMobile algorithm compared with clinical interpretation of the KardiaMobile ECG as the reference standard. Its sensitivity ranged between 92% and 99% per recorded ECG, with specificity between 92% and 98%. However, the external assessment centre (EAC) highlighted that diagnostic accuracy was reported on a per ECG recording and not a per person basis. Also, these 4 studies had 4 different patient populations with a pre-test probability of AF between 4.8% and 35.6%. The EAC also noted that KardiaMobile is not intended to be used to confirm the presence of AF as a standalone test but to help detect AF. All interpretations should be reviewed by healthcare professionals for clinical decision making. It is expected that false positives and negatives are likely to be captured by the clinical reviews.
