Handheld ECG vendor AliveCor has been particularly active in this regard. Its partnerships with GE Healthcare, the leading player in the traditional diagnostic cardiology markets of Resting and Stress ECG, enables the integration of patient data from AliveCor’s handheld KardiaMobile 6L ECG data directly into GE Healthcare’s MUSE Cardiac Management Systems. In a similar vein, its partnerships with Biotronik facilitates the integration of KardiaMobile and Biotronik’s ICM devices. This could prove to be a canny move for both parties, given that Biotronik currently competes in the oligopolistic ICM market in which its three competitors, Abbott, Boston Scientific, and Medtronic, have a combined market capitalisation of $368 billion.

AliveCor has also established agreements with medical device company (and recent RPM market entrant) Omron, Norwegian RPM vendor Dignio and consumer wearable company Zepp, (though an early integration with the Apple Watch has descended into acrimonious and costly litigation).


Another partnership looking to exploit the potential of ECG sensors in wearable devices is that between iRhythm, the second largest player in the market (when excluding ICM revenues) and Alphabet subsidiary Verily. In July 2022, iRhythm and Verily obtained FDA approval for their jointly developed Zio Watch and Zeus System, for identifying and monitoring Afib, incorporating iRhythm’s continuous PPG, AI-based algorithm. How this partnership will be affected by the recent announcement of layoffs at Verily remains to be seen.

Other companies to enter the fray include multinational tech firms Huawei and Samsung, specialist GPS technology company Garmin, and French connected health company Withings. Interestingly, one of the conditions of Withings’ FDA approval for its ECG-capable ScanWatch stipulated that the ECG feature can only be unlocked by a prescription from a healthcare provider.

Future outlook
Despite this flurry of activity, the Ambulatory Diagnostic Cardiology market refuses to sit still. Upcoming developments that could disrupt the market over short-to-medium term include a hand-held, 12-lead capability ECG device from Heartbeam, and a multimodality cardiac monitor (Holter, Event and MCT) with built-in 4G connectivity from Rhythmedix, both U.S.-based vendors. A domestic vendor in India, Dozee, recently released an ECG patch, while South Korea is also host to a number of Long-term ECG patch vendors in the process of international expansion. A new cohort of vendors in Europe and the U.S. are also looking to exploit the potential of AI for quicker and more accurate diagnosis.

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