According to the World Health Organisation, cardiovascular diseases claim almost 20 million lives every year and remain the leading cause of death worldwide. Although they are most often associated with heart attacks or strokes, serious complications do not always begin suddenly – sometimes their onset is far less noticeable.
For doctors, this raises a difficult question: how can they record something that is not happening during an examination? A standard electrocardiogram (ECG) shows the heart’s activity only at a specific moment, while even longer-term monitoring does not always coincide with less frequent episodes of heart rhythm disorders. As a result, some arrhythmias, particularly short episodes of atrial fibrillation, may go unnoticed until they cause more serious health problems.
As society ages and the prevalence of chronic diseases rises, this diagnostic gap is becoming more significant. Patients need monitoring not only in healthcare settings but also in their daily lives. For physicians, it is important to understand not just whether an abnormal heart rhythm occurred during a specific examination, but also how frequently such episodes happen, how long they last, under what conditions they arise, and whether their occurrence increases over time.
A system developed by Kaunas University of Technology (KTU) and other Lithuanian researchers aims to address this problem, and its solutions are being applied in Teltonika Telemedic’s TeltoHeart medical wristband. The system enables continuous heart rhythm monitoring, allows a more detailed ECG recording to be made using the same device and transmits the data to a doctor remotely.
Particularly Important for Post-Stroke Patients
Professor Dr Vaidotas Marozas, Director of the Biomedical Engineering Institute at KTU, emphasises that the system was first developed with patients in mind for whom undetected heart rhythm disorders can have particularly serious consequences. One such group is people who have suffered a stroke.
“The team chose to focus on post-stroke patients because atrial fibrillation is often short-lived and asymptomatic. As a result, standard examination methods – an electrocardiogram in a clinic or even Holter monitoring, where a patient wears a heart rhythm recording device for one or several days – often fail to detect such episodes,” says Marozas.
According to the KTU professor, heart rhythm disorders, particularly atrial fibrillation, are directly linked to an increased risk of ischaemic stroke. If an arrhythmia goes undetected, the patient may not receive the appropriate treatment, which increases the likelihood of a recurrent stroke.
The technology developed and continuously improved by KTU researchers and Teltonika Telemedic enables continuous heart rhythm monitoring. When a suspicious episode is detected, the system alerts the patient via an on-screen notification or vibration. This allows the event to be captured precisely when it occurs rather than days or weeks later during a doctor's appointment.
It does not require adhesive electrodes or additional wires – the user simply touches the electrodes integrated into the device. Within about a minute, a more detailed ECG recording is made, showing the heart’s electrical activity from several directions, and the data are then sent to the doctor.
In addition, the system will analyse not only the fact that an arrhythmia has occurred. It will use an arrhythmia aggregation parameter showing how episodes of rhythm disturbance are distributed over time – whether they occur evenly throughout the monitoring period or cluster into groups of short episodes.
“For a doctor, this kind of information would provide significantly more value than the mere fact that an arrhythmia was detected,” says Marozas. According to the KTU professor, such assessment makes it possible to monitor disease progression and assess a rising risk of complications at an earlier stage.
Patent Marks a Step Towards Wider Application
To ensure that the data are reliable in real-life conditions, a specialised signal processing algorithm has also been integrated into the system. Movement, changes in body position or physical activity can distort signals, so the system first assesses their quality and only then sends suitable segments for more detailed analysis.
“The system distinguishes dangerous arrhythmias from noise caused by everyday activity using a multi-stage signal analysis process,” says Marozas.
The patent granted to the system confirmed its technological novelty and became an important step towards further clinical trials and wider application. According to Marozas, the patent covers not only the wrist-worn device itself, but also arrhythmia analysis algorithms, arrhythmia aggregation and other new assessment parameters.
“The patent obtained is an important recognition of many years of interdisciplinary work and technological novelty. However, the greatest motivation remains saving patients’ lives, improving their quality of life and advancing medicine in a way that benefits society,” says Marozas.
A large interdisciplinary team contributed to both the patent application and the development of the technology, including KTU researcher Andrius Petrėnas, cardiologist Justinas Bacevičius from Vilnius University Hospital Santaros Clinics, KTU researchers Andrius Sološenko, Saulius Daukantas and Monika Butkuvienė, as well as KTU doctoral students, engineers, and medical residents from Vilnius University Hospital Santaros Clinics. For patients, the “TeltoHeart” device primarily means a simpler route to a doctor’s consultation. According to Ilgevičius, if a person is recovering at home after surgery or a serious illness, they do not necessarily need to travel to a healthcare facility for tests.
The solution can now be implemented in the majority of healthcare institutions across Lithuania. Patients can use the solution together with a physician's consultation, while telemedicine services are already available in some outpatient clinics through projects funded by the European Union.
Nevertheless, broader reimbursement of such solutions for at-risk patients, such as people who have suffered a stroke, remains a future objective. According to the technology's developers, reimbursement policies may ultimately determine whether advanced remote monitoring solutions become widely accessible to the patients who need them most.