Wearable electrocardiogram devices in patients with congenital long QT syndrome: The SMART-QT study.

Digital health Long QT syndrome QT interval Remote monitoring Smartwatch

Journal

Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655

Informations de publication

Date de publication:
24 Apr 2024
Historique:
received: 29 10 2023
revised: 12 02 2024
accepted: 15 02 2024
medline: 5 5 2024
pubmed: 5 5 2024
entrez: 4 5 2024
Statut: aheadofprint

Résumé

In patients with congenital long QT syndrome (LQTS), the risk of ventricular arrhythmia is correlated with the duration of the corrected QT interval and the changes in the ST-T wave pattern on the 12-lead surface electrocardiogram (12L-ECG). Remote monitoring of these variables could be useful. To evaluate the abilities of two wearable electrocardiogram devices (Apple Watch and KardiaMobile 6L) to provide reliable electrocardiograms in terms of corrected QT interval and ST-T wave patterns in patients with LQTS. In a prospective multicentre study (ClinicalTrials.gov identifier: NCT04728100), a 12L-ECG, a 6-lead KardiaMobile 6L electrocardiogram and two single-lead Apple Watch electrocardiograms were recorded in patients with LQTS. The corrected QT interval and ST-T wave patterns were evaluated manually. Overall, 98 patients with LQTS were included; 12.2% were children and 92.8% had a pathogenic variant in an LQTS gene. The main genotypes were LQTS type 1 (40.8%), LQTS type 2 (36.7%) and LQTS type 3 (7.1%); rarer genotypes were also represented. When comparing the ST-T wave patterns obtained with the 12L-ECG, the level of agreement was moderate with the Apple Watch (k=0.593) and substantial with the KardiaMobile 6L (k=0.651). Regarding the corrected QT interval, the correlation with 12L-ECG was strong for the Apple Watch (r=0.703 in lead II) and moderate for the KardiaMobile 6L (r=0.593). There was a slight overestimation of corrected QT interval with the Apple Watch and a subtle underestimation with the KardiaMobile 6L. In patients with LQTS, the corrected QT interval and ST-T wave patterns obtained with the Apple Watch and the KardiaMobile 6L correlated with the 12L-ECG. Although wearable electrocardiogram devices cannot replace the 12L-ECG for the follow-up of these patients, they could be interesting additional monitoring tools.

Sections du résumé

BACKGROUND BACKGROUND
In patients with congenital long QT syndrome (LQTS), the risk of ventricular arrhythmia is correlated with the duration of the corrected QT interval and the changes in the ST-T wave pattern on the 12-lead surface electrocardiogram (12L-ECG). Remote monitoring of these variables could be useful.
AIM OBJECTIVE
To evaluate the abilities of two wearable electrocardiogram devices (Apple Watch and KardiaMobile 6L) to provide reliable electrocardiograms in terms of corrected QT interval and ST-T wave patterns in patients with LQTS.
METHODS METHODS
In a prospective multicentre study (ClinicalTrials.gov identifier: NCT04728100), a 12L-ECG, a 6-lead KardiaMobile 6L electrocardiogram and two single-lead Apple Watch electrocardiograms were recorded in patients with LQTS. The corrected QT interval and ST-T wave patterns were evaluated manually.
RESULTS RESULTS
Overall, 98 patients with LQTS were included; 12.2% were children and 92.8% had a pathogenic variant in an LQTS gene. The main genotypes were LQTS type 1 (40.8%), LQTS type 2 (36.7%) and LQTS type 3 (7.1%); rarer genotypes were also represented. When comparing the ST-T wave patterns obtained with the 12L-ECG, the level of agreement was moderate with the Apple Watch (k=0.593) and substantial with the KardiaMobile 6L (k=0.651). Regarding the corrected QT interval, the correlation with 12L-ECG was strong for the Apple Watch (r=0.703 in lead II) and moderate for the KardiaMobile 6L (r=0.593). There was a slight overestimation of corrected QT interval with the Apple Watch and a subtle underestimation with the KardiaMobile 6L.
CONCLUSIONS CONCLUSIONS
In patients with LQTS, the corrected QT interval and ST-T wave patterns obtained with the Apple Watch and the KardiaMobile 6L correlated with the 12L-ECG. Although wearable electrocardiogram devices cannot replace the 12L-ECG for the follow-up of these patients, they could be interesting additional monitoring tools.

Identifiants

pubmed: 38704288
pii: S1875-2136(24)00054-8
doi: 10.1016/j.acvd.2024.02.010
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT04728100']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Masson SAS.

Auteurs

Antoine Delinière (A)

National Reference Centre for Inherited Arrhythmia of Lyon (CERA), Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Université Claude-Bernard Lyon-1, MeLiS, CNRS UMR 5284, INSERM U1314, Institut NeuroMyoGène, 69008 Lyon, France; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart).

Francis Bessière (F)

Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Paediatric and Congenital Heart Disease Medico-Surgical Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Université Claude-Bernard Lyon-1, LabTau, Inserm, 69003 Lyon, France.

Leslie Placide (L)

Service de Cardiologie, Centre de Compétence des Troubles du Rythme Cardiaque d'Origine Héréditaire, Hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 34295 Montpellier, France.

Jean-Luc Pasquié (JL)

Service de Cardiologie, Centre de Compétence des Troubles du Rythme Cardiaque d'Origine Héréditaire, Hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 34295 Montpellier, France; CNRS UMR9214, Inserm U1046, PHYMEDEXP, Université de Montpellier, 34295 Montpellier, France.

Christelle Haddad (C)

Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France.

Solenn Tirel (S)

National Reference Centre for Inherited Arrhythmia of Lyon (CERA), Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France.

Hajira Mokhtar (H)

National Reference Centre for Inherited Arrhythmia of Lyon (CERA), Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France.

Elodie Morel (E)

National Reference Centre for Inherited Arrhythmia of Lyon (CERA), Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France.

Kevin Gardey (K)

Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France.

Arnaud Dulac (A)

Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France.

Geoffroy Ditac (G)

Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France.

Frédéric Sacher (F)

European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart); Institut LIRYC, Centre de référence des MAladies RYthmiques héréditaire (CMARY), Bordeaux University Hospital, 33000 Bordeaux, France; Université de Bordeaux, Inserm, CRCTB, U1045, 33000 Bordeaux, France.

Isabelle Denjoy (I)

European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart); Service de Cardiologie, Centre de Référence des Troubles du Rythme Cardiaque d'Origine Héréditaire, Hôpital Bichat-Claude-Bernard, AP-HP, 75018 Paris, France.

Philippe Chevalier (P)

National Reference Centre for Inherited Arrhythmia of Lyon (CERA), Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Université Claude-Bernard Lyon-1, MeLiS, CNRS UMR 5284, INSERM U1314, Institut NeuroMyoGène, 69008 Lyon, France; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart). Electronic address: philippe.chevalier@chu-lyon.fr.

Classifications MeSH