Carnlöf P et al. European Journal of Cardiovascular Nursing. March 2021
Link to full publication, open access:

  • Largest study of its kind with 821 patients (women-only) with palpitations
  • Used Coala for 60-day monitoring.
  • Over 200,000 individual ECG strips analyzed.
  • The direct ECG response of the Coala contributed to reduced levels of anxiety, depression and symptoms of palpitations.
  • The direct ECG response of the Coala also led to an increased quality of life (HRQOL)
  • Study shows the value of long-term monitoring and that most episodes of palpitations are benign

Palpitations, particularly common in women, are generally considered benign symptoms rarely caused by clinically important arrhythmias. Nevertheless, palpitations may cause anxiety, depression, and decreased health-related quality of life (HRQOL). This study investigates to what degree palpitations cause symptoms and affect HRQOL in women and whether direct feedback of underlying heart rhythm during palpitations decrease anxiety and depression and increase HRQOL in women.

The study included 821 women, age 21–88 years (mean 57 ± 11 years), with symptomatic palpitations. For 60 days, the participants used the Coala twice a day and when symptoms were present. Non-benign arrhythmias were also analyzed manually. Questionnaires addressing anxiety and depression- Hospital Anxiety and Depression Scale (HADS), Generalized Anxiety Disorder (GAD-7), HRQOL (RAND-36), and Symptoms Checklist: Frequency and Severity (SCL)-were analyzed before and after the data were collected.

A total of 101 804 ECG recordings (in total 203 608 ECG strips) were automatically analyzed. In 94%, sinus rhythm or premature atrial/ventricular contraction were recorded; in 6%, atrial fibrillation or supraventricular tachycardia were recorded. Apart from PVCs, no ventricular arrhythmias were documented. Anxiety and depression decreased (P < 0.001) as did frequency and severity of symptoms, and HRQOL increased in all domains (P < 0.001) at the 2-month follow- up.

Instant analysis using Coala with direct response during palpitations decreases symptoms, anxiety, and depression and increases HRQOL in women.