Usefulness, pitfalls and interpretation of handheld single‑lead electrocardiograms

Witvliet, M.; Karregat, Evert P.M.; Himmelreich, Jelle C L; Jong, Jonas S.S.G. de; Lucassen, Wim A M; Harskamp, Ralf E.

doi:10.1016/j.jelectrocard.2021.02.011

Cited by 23 publications

(14 citation statements)

References 5 publications

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“…Of all CE certified and FDA approved devices, the AliveCor heart monitor is among those most extensively validated against 12L-ECGs as reference standard. 13 Generally, the device has been studied for accurate detection of atrial fibrillation (AF). 14 Validation studies in which the usability of QT times was assessed are, however, lacking.…”

Section: Introductionmentioning

confidence: 99%

Manual QT interval measurement with a smartphone-operated single-lead ECG versus 12-lead ECG: a within-patient diagnostic validation study in primary care

et al. 2021

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ObjectiveTo determine the accuracy of QT measurement in a smartphone-operated, single-lead ECG (1L-ECG) device (AliveCor KardiaMobile 1L).DesignCross-sectional, within-patient diagnostic validation study.Setting/participantsPatients underwent a 12-lead ECG (12L-ECG) for any non-acute indication in primary care, April 2017–July 2018.InterventionSimultaneous recording of 1L-ECGs and 12L-ECGs with blinded manual QT assessment.Outcomes of interest(1) Difference in QT interval in milliseconds (ms) between the devices; (2) measurement agreement between the devices (excellent agreement <20 ms and clinically acceptable agreement <40 ms absolute difference); (3) sensitivity and specificity for detection of extreme QTc (short (≤340 ms) or long (≥480 ms)), on 1L-ECGs versus 12L-ECGs as reference standard. In case of significant discrepancy between lead I/II of 12L-ECGs and 1L-ECGs, we developed a correction tool by adding the difference between QT measurements of 12L-ECG and 1L-ECGs.Results250 ECGs of 125 patients were included. The mean QTc interval, using Bazett’s formula (QTcB), was 393±25 ms (mean±SD) in 1L-ECGs and 392±27 ms in lead I of 12L-ECGs, a mean difference of 1±21 ms, which was not statistically different (paired t-test (p=0.51) and Bland Altman method (p=0.23)). In terms of agreement between 1L-ECGs and lead I, QTcB had excellent agreement in 66.9% and clinically acceptable agreement in 93.4% of observations. The sensitivity and specificity of detecting extreme QTc were 0% and 99.2%, respectively. The comparison of 1L-ECG QTcB with lead II of 12L-ECGs showed a significant difference (p=<0.01), but when using a correction factor (+9 ms) this difference was cancelled (paired t-test (p=0.43) or Bland Altman test (p=0.57)). Moreover, it led to improved rates of excellent (71.3%) and clinically acceptable (94.3%) agreement.ConclusionSmartphone-operated 1L-ECGs can be used to accurately measure the QTc interval compared with simultaneously obtained 12L-ECGs in a primary care population. This may provide an opportunity for monitoring the effects of potential QTc-prolonging medications.

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Section: Introductionmentioning

confidence: 99%

Manual QT interval measurement with a smartphone-operated single-lead ECG versus 12-lead ECG: a within-patient diagnostic validation study in primary care

et al. 2021

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“…Black dashed vertical lines are reported for convenience. Based on the use of a single-lead ECG, our approach would be suitable for a basic heart monitoring of rhythms to detect arrhythmias, such as atrial fibrillation, as well as to examine heart rate variability during specific sleep stages, as previously reported [ 39 , 40 ].…”

Section: Tests and Discussionmentioning

confidence: 99%

Long-Term Polygraphic Monitoring through MEMS and Charge Transfer for Low-Power Wearable Applications

Manoni

Gumiero

Zampogna

et al. 2022

Sensors

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In this work, we propose a wireless wearable system for the acquisition of multiple biopotentials through charge transfer electrostatic sensors realized in MEMS technology. The system is designed for low power consumption and low invasiveness, and thus candidates for long-time monitoring in free-living conditions, with data recording on an SD or wireless transmission to an external elaborator. Thanks to the wide horizon of applications, research is very active in this field, and in the last few years, some devices have been introduced on the market. The main problem with those devices is that their operation is time-limited, so they do not match the growing demand for long monitoring, which is a must-have feature in diagnosing specific diseases. Furthermore, their versatility is hampered by the fact that they have been designed to record just one type of signal. Using ST-Qvar sensors, we acquired an electrocardiogram trace and single-channel scalp electroencephalogram from the frontal lobes, together with an electrooculogram. Excellent results from all three types of acquisition tests were obtained. The power consumption is very low, demonstrating that, thanks to the MEMS technology, a continuous acquisition is feasible for several days.

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“…There are many connected ECGs available on the market. Thanks to their connectivity with a Smartphone, sharing recordings is now easy between patients and doctors [49]. The principle consists in placing two fingers of each hand on the device and the result is displayed directly on the Smartphone.…”

Section: Examples Of Connected Medical Devicesmentioning

confidence: 99%

Smartphone and Surgery, Reality or Gadget?

Boughizane¹,

Bannour²,

Bannour³

et al. 2022

Medical Education for the 21st Century

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Surgical care is an essential component of health care. This basic universal right is not available to everyone. Indeed, countries with low economic resources suffer from a lack of access to surgical care and the most developed countries will have to reduce the cost of health care to ensure the sustainability of provided care quality. New communication technologies have invaded the field of health and have led to the development of a new concept of mobile health. The purpose of this paper is to answer the following question: Can these new tools, and in particular the Smartphone, remedy, even partially, the lack of health care in poor countries and reduce the cost of health care in rich countries? New communication tools, led by the Smartphone, have the capacity to capture, store, retrieve and transmit data to provide instant and personalized information to individuals. This information could be a key element in health systems and can contribute to monitoring health status and improving patient safety and care quality. Mobile telephony via applications and connected objects can facilitate the pre-, intra- and post-operative management of patients. These mobile systems also facilitate the collection and transmission of data. This will allow better analysis of this data and will greatly pave the way to the introduction of artificial intelligence in medicine and surgery. The Smartphone can be used as an important tool for both, diagnosis care and surgical training. Surgeons must adapt their equipment to local resources while respecting safety standards. Covid-19 has put health systems around the world under severe strain. Decision-makers are being forced to make adjustments. The long-vaunted digital health is becoming a reality and a necessity. Healthcare authorities and strategy specialists face challenges in terms of disease prevention and therapy, as well as in terms of health economics and management.

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Usefulness, pitfalls and interpretation of handheld single‑lead electrocardiograms

Cited by 23 publications

References 5 publications

Manual QT interval measurement with a smartphone-operated single-lead ECG versus 12-lead ECG: a within-patient diagnostic validation study in primary care

Manual QT interval measurement with a smartphone-operated single-lead ECG versus 12-lead ECG: a within-patient diagnostic validation study in primary care

Long-Term Polygraphic Monitoring through MEMS and Charge Transfer for Low-Power Wearable Applications

Smartphone and Surgery, Reality or Gadget?

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