Wellue Holter ECG Monitor, Professional 12 Lead ECG Monitors, 24-Hour ECG Holter Record With AI Analysis, Work With Mac & Windows PDF Report Export, Portable Heart Monitor For Home Use

This is review of Wellue 12 lead (TH12 model) Holter Monitor. Although it costs a significant amount of money it still is an astounding value, especially considering it's a 12-lead 24-hour monitor that includes online ECG analysis at no additional cost. In a private medical setting, it could cost the same or more for just one report. The package includes everything, I mean everything including the software on a USB drive, two 10 electrode pack (ten needed for one 24 hour recording) and 6 batteries (one needed for one 24 hour recording). Commendable attention to detail.The most important aspect of the analysis is obtaining a clear ECG recording without any interference. Minimising interference requires meticulous attention to skin preparation and electrode placement. Ensuring clear ECG most of the time is vital to avoid difficulties in interpretation. Reading this fully should help in achieving this.1. First things first. The device comes with ‘Operator’s Manual’. Read it fully. Although it can look complicated all becomes very easy after the first use.2. Skin preparation is the essential first step. Shave any hair where electrodes attach to the skin, as hair can hinder electrode contact and fall off. Afterwards, rub the skin with a damp cloth to remove oils and debris, then dry it for better electrode contact.3. Understanding the leads are helpful. For instance, LL stands for Left Leg, RL for Right Leg, LA for Left Arm, and RA for Right Arm. While a standard ECG involves placing these leads on limbs, for a 24-hour recording, these are necessarily placed on the chest.4. Pay close attention to the positions outlined in the booklet. Identifying the fourth intercostal space is important. To locate it, run your finger from the front of neck down the breastbone until you feel a bump just a few fingers breadth from neck. Moving to the sides from there, you'll feel the bone, marking the end of the second rib. The space below is the second intercostal space. Count down to the third and then the fourth. V1 is just to the right of the breastbone. Attach V1 electrode on the right and V2 to the left. Next use a mirror to find the mid-axillary line, which is an imaginary line down from middle of the collar bone. V4 is in the fifth intercostal space along this line. V3 goes midway between V2 and V4. Face the left side of your chest in front of a mirror, and place V6 at the same level as V4, in the middle of the left chest in side view. No need to count rib space for V6. V5 is between V6 and V4.5. Limb leads (LL, LA, RL, RA) have the most potential to give artifacts if placed improperly. Placing electrodes on bony prominences minimises baseline disturbances. LA (left side) and RA (right side) can go on the outer third of collarbones, to minimise artifacts in recordings.For LL and RL leads, feel the lower edge of rib cage on sides of chest and place electrode over the lower ribs in the outer chest on right (RL) and left (LL).Ensure electrodes are sticking well to the skin by pressing all around its edges, avoiding hard pressure on the center to prevent gel from spreading out and thus drying faster which can cause air pockets.6. When attaching electrode-wires ensure wires are not entangled by separating them. Otherwise they can pull each other and distort recordings. Wear the Holter device around your neck (preferred than belt as there won’t put tension especially on LL, LA wires) and again check there is no tension or pulling of the electrode wires when you move your arms, bend or turn.7. Accurate lead placement is crucial to obtaining expected typical ECG wave patterns. Incorrect lead placement can result in unusual patterns. Don’t mix up left and right (LL, RL etc.).8. Despite meticulous attention, some artifacts are inevitable with certain movements but most of the recordings should be clear. That is why the accompanying manual cautions ‘Stay in a resting state during the recording process..’ If you experience symptoms, (that’s when you want to know if symptoms are related to heart) stand still or sit down still to improve recording quality.Despite the right advice in the booklet to rest during the recordings except small amount like walking, I went for a brisk walk for 20 minutes, did several housework and used treadmill walking at 7kph for 30 minutes to see how much interference occurs.See attached images. Image 1 shows what a normal recording looks like. Images 2, 3 and 4 shows interference. Image 5 while brisk walking on treadmill. No heart irregularity in any of these. What you see are all interference due to muscle contractions and electrode movement.Each 24-hour recording uses ten electrodes, which are your main ongoing expense. One can continue to do further two 24 hour recordings on the same set of electrodes by not removing them. Sometimes 3 day recordings gives more useful information. Just take out the battery then the SD card from Holter Recorder without disconnecting other things. I did for 3 days and quality of ECG on third day was as good as the first day, as electrodes didn’t dry out.IMPORTANT: Remove the SD card and analyze data on ‘Wellue AI-ECG Analysis System’ before starting the next 24-hour recording and replace battery with a new one, as one is enough for just one 24-hour recording.Can it be improved further? Yes, and most are software related and one (image 6) hardware.- ‘Event Marker’. At present, it serves no useful purpose as you cannot locate the event marked in the software easily. See event mark in image 2. An event marker tab is needed in the ‘view ECG’ screen. By the way, left panel has a link to ECG of all the arrhythmias the software has identified. Click on ‘►’ next to events on left of screen. The arrow turns downward and if you click it will take to page where the specified arrhythmia seen. At the bottom of the screen click on ‘▼’arrow next to ‘Lead V1’ etc to see patterns in other leads.- Adding a scroll bar to the "View ECG" report to move rapidly through the report would make it easier to navigate.- Displaying heart rate in numbers on each page can provide a quick way to assess heart rate.- Consider a design improvement for the battery compartment to reduce the risk of breaking the metal contact. See image 6. Inserting the battery pushes the contact downwards. This may eventually break. I avoid it by holding thin blade to press it back when inserting the battery.

This is an excellent device. My doctor friend was floored that this is available to just buy on Amazon. Back when he practiced, you needed to go to the hospital or a specialised clinic for this.It's not very hard to put the leads in the right spots. The recording device is small and light. The resulting output was acceptable to both my cardiologists. One of them pointed out that Wellue doesn't have all the medical certifications it might need, but as far as he could tell the ECG was as good as anything he's seen and helpful in diagnosis.The important difference with having this, vs getting a similar kit from a clinic/hospital is:- It's a 12-lead, not a 2-lead, like the Holter monitors they usually give you.- You can start and stop it whenever you want, so if you have a problem that comes and goes, you are more likely to catch it.The AI analysis basically produces a report almost identical to the one from the clinic-provided 2-lead ECG, but in full 12-lead detail. It works well, though it occasionally mis-categorises a shift in posture as an ECG event, but that's rare enough not to be a problem.I used it for tracking down and measuring Paroxysmal Atrial Fibrillation, and it was helpful. In particular, when it was happening frequently, I put it on one evening and was able to catch the whole AF episode from start to finish. And now that the Afib is gone, it's been possible to prove to myself and my doctors that it is gone, by providing a 24h recording that shows very few ectopic beats. So, the device has served its purpose so far and I'm glad I bought it, as expensive as it is.Room for improvement would be:- It doesn't last 24h on rechargeable batteries- Should really be USB-rechargeable with a replaceable USB battery for durability, I think...- Can only use it in 12-lead (10 pads) or 8-lead (6 pads) configuration. For more frequent monitoring it would be nice if there was a mode supporting just 2 or 3 contact points, to just check for frequency of PACs rather than get a full detailed reading. Main reason being that wearing so many contact pads is uncomfortable and leaves lots of glue residue.

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This provides continuous traces from all leads. There does not appear to be a way of printing out a straight forward 12 lead ecg on a single piece of A4