Wireless Smartphone ECG Enables Large‐Scale Screening in Diverse Populations

Journal of Cardiovascular Electrophysiology - Tập 26 Số 5 - Trang 520-526 - 2015
ZACHARY C. HABERMAN1, R Jahn1, Rupan Bose1, Han Naung Tun1, Jerold S. Shinbane1, Rahul Doshi1, Philip M. Chang1, Leslie A. Saxon1
1Keck School of Medicine of USC, Los Angeles, California, USA

Tóm tắt

Twelve‐Lead ECG as a Cardiovascular Screening ToolBackground

The ubiquitous presence of internet‐connected phones and tablets presents a new opportunity for cost‐effective and efficient electrocardiogram (ECG) screening and on‐demand diagnosis. Wireless, single‐lead real‐time ECG monitoring supported by iOS and android devices can be obtained quickly and on‐demand. ECGs can be immediately downloaded and reviewed using any internet browser.

Objective

We compared the standard 12‐lead ECG to the smartphone ECG in healthy young adults, elite athletes, and cardiology clinic patients. Accuracy for determining baseline ECG intervals and rate and rhythm was assessed.

Methods

In 381 participants, 30‐second lead I ECG waveforms were obtained using an iPhone case or iPad. Standard 12‐lead ECGs were acquired immediately after the smartphone tracing was obtained. De‐identified ECGs were interpreted by automated algorithms and adjudicated by two board‐certified electrophysiologists.

Results

Both smartphone and standard ECGs detected atrial rate and rhythm, AV block, and QRS delay with equal accuracy. Sensitivities ranged from 72% (QRS delay) to 94% (atrial fibrillation). Specificities were all above 94% for both modalities.

Conclusion

Smartphone ECG accurately detects baseline intervals, atrial rate, and rhythm and enables screening in diverse populations. Efficient ECG analysis using automated discrimination and an enhanced smartphone application with notification capabilities are features that can be easily incorporated into the acquisition process.

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Tài liệu tham khảo

10.1161/CIRCULATIONAHA.107.711465

10.1111/joim.12184

10.3109/07853890.2011.594807

10.1136/bjsports-2012-092067

10.1016/S0735-1097(98)00175-2

10.1016/j.pcad.2013.08.006

10.1136/bmj.39280.660567.55

Hankil Kim J, 2013, Clinical inquiry: Do asymptomatic adults need screening EKGs, J Fam Pract, 62, 438

10.1161/CIRCULATIONAHA.107.181423

10.3310/hta9400

10.1160/TH13-02-0165

10.1161/01.STR.22.8.983

10.1016/S0140-6736(12)61728-0

10.1016/S0002-9149(99)80240-9

10.1161/01.CIR.82.4.1106

10.1161/01.CIR.89.1.224

10.1161/hc4301.098254

10.1016/j.jacc.2003.03.002

10.1046/j.1540-8167.2001.00369.x

10.1093/eurheartj/ehl137

10.1097/00005768-199709000-00003

10.1136/hrt.2011.227330

10.1016/S0735-1097(87)80121-3

10.1093/eurheartj/ehp473

10.1111/jce.12097

10.1016/S0735-1097(12)60727-X

IHS Electronics and Media:Wearable Technology‐Market Assessment. An IHS Whitepaper.http://www.academia.edu/6769970/Wearable_Technology_Market_Assessment. Accessed July 15 2014.

Projected Wearables Unit Shipments Worldwide 2014 and 2018 (fee‐based).Statista.http://www.statista.com/statistics/296565/wearables‐worldwide‐shipments/Published 2014. Accessed July 15 2014.

10.1016/j.jelectrocard.2013.11.007

10.1016/j.jelectrocard.2014.01.004

10.1088/0967-3334/34/9/1075

10.1016/j.jelectrocard.2014.10.005

10.1016/0002-9149(87)90317-1

10.1016/j.jelectrocard.2006.05.025

10.1016/j.ijcard.2013.01.220

TarakjiKG WazniOM CallahanT KanjM HakimAH WolskiK WilkoffBL SalibaW LindsayBD:Using a novel wireless system in monitoring patients after the atrial fibrillation ablation procedure: The iTransmit study. Heart Rhythm [Internet]. Available from:http://www.heartrhythmjournal.com/article/S1547527114013125/abstract. Accessed December 13 2014.

10.1136/bjsports-2012-092069

10.1136/heartjnl-2013-305149

10.7326/0003-4819-155-6-201109200-00006

10.1016/S0002-9149(99)80198-2

Jellins J, 2013, Brugada syndrome, Hong Kong Med J, 19, 159

10.1016/j.jelectrocard.2014.09.006

10.1093/eurheartj/ehq025

Zeldis SM, Cardiovascular complaints. Correlation with cardiac arrhythmias on 24‐hour electrocardiographic monitoring, Chest, 78, 456

Bass EB, 1990, The duration of Holter monitoring in patients with syncope. Is 24 hours enough, Arch Intern Med, 150, 1073, 10.1001/archinte.1990.00390170103022

10.1097/HCR.0000000000000055