On the use of chest leads in clinical electrocardiography

Roth, Irving R.

doi:10.1016/s0002-8703(35)90347-7

Cited by 46 publications

(1 citation statement)

References 15 publications

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“…These leads are generated similarly to V1 through V6, but with RA used as a proxy for Wilson's negative pole. This approach was first investigated in the 1930s, and as it is considered diagnostically similar to the current precordial leads it has previously been recommended during the 1990s for use in emergency settings (36)(37)(38)(39)(40)(41). The second approach, recommended by Samol et al, is to use a similar technique but enclose the right wrist in the left hand, thereby combining LA and RA in the negative pole (20).…”

Section: Discussionmentioning

confidence: 99%

Einthoven and Precordial Lead Accuracy of Smartwatch-Acquired Electrocardiographs: A Review of the Literature

Wilkinson-Stokes

2020

Australasian Journal of Paramedicine

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IntroductionThis review aims to summarise the literature regarding the ability of commercial smartwatch products to produce an electrocardiograph of diagnostic quality for interpreting Einthoven and precordial leads. Methods PubMed, Embase, MEDLINE Complete, Web of Science, and Scopus were systematically searched. Articles were screened by a sole investigator against the inclusion criteria – first by title, then abstract, then full text. The reference lists of included articles were also screened. The inclusion criteria were: discussion of smartwatch-acquired tracing of Einthoven or precordial lead accuracy, and demonstrating sufficient rigor when undergoing critical appraisal using the Joanna Briggs Institute evaluation tools. A synopsis of results was provided in a summary of information table. ResultsTwelve articles were identified for inclusion, nine of which had physician (cardiology or emergency specialty) evaluation of tracings, one of which had statistical comparison of wave duration and amplitude, and two of which were expert commentary. Only evaluations of Apple Watch products were discovered during the literature search. All leads in all studies were considered suitable for interpretation, with no clinically significant differences. Four studies found that 100% of patients were able to accurately use a smartwatch as an electrocardiogram after a brief tutorial. ConclusionThe current early evidence, based largely on visual evaluations by cardiologists during the previous year, suggests that electrocardiograph abnormality recorded by this technology is sufficiently precise to be presumed accurate until proven otherwise.

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