Continuous ECG, clinically routed.
A continuous ECG analysis platform — detecting arrhythmias, quantifying burden, and routing clinically meaningful findings into a structured two-tier escalation workflow.
Detection
Eight independent analytical streams running continuously on raw ECG and PPG-derived signals.
Atrial fibrillation
Binary presence, episode probability, rolling 24-hour AF burden percentage.
Asystole / pause
Maximum RR pause duration measured to millisecond precision.
AV-block flagging
Presence and severity indication with clinical-review prompting.
PVC / PAC quantification
Per-minute counts with banded thresholds for escalation.
Heart-rate variability
SDNN & RMSSD — gold-standard HRV metrics from RR-interval series.
Signal quality grading
Waveform fidelity, motion artifact, and lead-contact assessment.
Episode log
Timestamped events with physiologic snapshots, classed by clinical action.
Per-recording report
Summary metrics, arrhythmia burden chart, HRV radar visualisation.
Escalation thresholds
Two-tier band model. Orange — clinical attention warranted. Red — urgent action. Values derived from published guidelines, configurable per template.
| Parameter | Orange | Red | Clinical rationale |
|---|---|---|---|
| Pause / asystole duration | ≥ 2.5 s | ≥ 4.0 s | ≥3s often symptomatic; ≥4s pacing consideration (ESC 2021) |
| Ectopic frequency (PVC/PAC) | ≥ 10 /min | ≥ 30 /min | Frequent ectopy linked to cardiomyopathy risk (Baman 2010) |
| AF burden (24h rolling) | ≥ 5% | ≥ 20% | Aligned with CHA₂DS₂-VASc stratification guidance |
| Heart rate (sustained) | > 110 or < 50 | > 130 or < 40 | Standard cardiac-ward escalation thresholds |
Clinical templates
Three configurations ship with the system. Sites deploy with a template and tune from there.
Cardiac Standard
General cardiac-ward monitoring. Default thresholds across all parameters; balanced escalation. Suitable for stable post-cardiac patients and general cardiac wards.
Post-Ablation
AF recurrence surveillance after catheter ablation. Lower AF-burden trigger thresholds; tighter ectopic monitoring during the 3-month blanking period.
Heart Failure
Tachy / desat / hypotension emphasis. Lower tachycardia thresholds, integrated SpO₂ desaturation. Suitable for HF-decompensation surveillance.
Production state & blockers
Production
- Production UI live at frontend-orcaa-cardiac-production.up.railway.app
- Rules engine well-tested with comprehensive unit coverage
- Three clinical templates configured and deployment-ready
- Episode logging, HRV computation, per-recording reports working end-to-end
In flight
APP 8 requires AU-region processing. Migration from Railway US to Fly.io Sydney is documented and executing.
UI flow and escalation routing refinement, scoped and progressing alongside the migration.
"Production UI live, rules engine well-tested, evidence-grounded thresholds, ready for prospective pilot validation."
Prospective benchmark numbers (sensitivity, specificity, AUC) are not yet established — that evidence runs through the first clinical pilot.
Devices & roadmap
Device-agnostic ingestion. Two pathways active, more under evaluation.
Device integration
Standard BLE heart-rate service. Production-ready gateway for bench testing and rapid prototyping.
Wearable with raw ECG and bioimpedance respiration. SpO₂/temperature variant pending evaluation.
Generic device-source field accepts any ingestion partner under evaluation.
Roadmap
- NowComplete AU server migration; finalise escalation/interface tuning; prepare for first clinical pilot.
- Q1First prospective pilot in cardiac-ward / cardiac-rehab; establish baseline against adjudicated outcomes.
- Q2Integration with FDA/CE-marked wearable partner for ambulatory post-discharge cardiac surveillance.
- Q3+Refinement from real-world data; additional templates (post-MI, atrial-flutter cohorts, etc.).