| Title: |
Feasibility of combining serial smartphone single-lead electrocardiograms for the diagnosis of ST-elevation myocardial infarction. |
| Authors: |
Muhlestein, Joseph Boone1,2 (AUTHOR); Anderson, Jeffrey L.1,2 (AUTHOR); Bethea, Charles F.3 (AUTHOR); Severance, Harry W.4,5 (AUTHOR); Mentz, Robert J.5 (AUTHOR); Barsness, Gregory W.6 (AUTHOR); Barbagelata, Alejandro7 (AUTHOR); Albert, David8 (AUTHOR); Le, Viet T.1,9 (AUTHOR); Bunch, T. Jared1,10 (AUTHOR); Yanowitz, Frank1,2 (AUTHOR); May, Heidi T.1 (AUTHOR); Chisum, Benjamin1 (AUTHOR); Ronnow, Brianna S.1 (AUTHOR); Muhlestein, Joseph Brent1,2 (AUTHOR) JBrent.Muhlestein@imail.org; Duke University Cooperative Cardiovascular Society (DUCCS) investigators (CORPORATE AUTHOR) |
| Source: |
American Heart Journal. Mar2020, Vol. 221, p125-135. 11p. |
| Abstract: |
Background: The rate-limiting step in STEMI diagnosis often is the availability of a 12-lead electrocardiogram (ECG) and its interpretation. The potential may exist to speed the availability of 12-lead ECG information by using commonly available mobile technologies. We sought to test whether combining serial smartphone single-lead ECGs to create a virtual 12-lead ECG can accurately diagnose STEMI.Methods: Consenting patients presenting with symptoms consistent with a possible STEMI had contemporaneous standard 12-lead and smartphone '12-lead equivalent' ECG (produced by electronically combining serial single-lead ECGs) recordings obtained. Matched ECGs were evaluated qualitatively and quantitatively by a panel of blinded readers and classified as STEMI/STEMI equivalent (LBBB), Not-STEMI, or uninterpretable. Interpretable ECG pairs were graded as showing good, fair, or poor correlation.Results: Two hundred four subjects (age = 60 years, males = 57%, STEMI activation = 45%) were enrolled from 5 international sites. Smartphone ECG quality was graded as good in 151 (74.0%), fair in 32 (15.7%), poor in 8 (3.9%), and uninterpretable in 13 (6.4%). A STEMI/STEMI equivalent diagnosis was identified by standard 12-lead ECG in 57/204 (27.9%) recordings. For all interpretable pairs of smartphone ECGs compared with standard ECGs (n = 190), the sensitivity, specificity, and positive and negative predictive values for STEMI/STEMI equivalent by smartphone were 0.89, 0.84, 0.70 and 0.95, respectively.Conclusions: A '12-lead equivalent' ECG obtained from multiple serial single-lead ECGs from a smartphone can identify STEMI with good correlation to a standard 12-lead ECG. This technology holds promise to improve outcomes in STEMI by enhancing the reach and speed of diagnosis and thereby early treatment. [ABSTRACT FROM AUTHOR] |
| Database: |
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