Accuracy of a Single-Lead ECG Device for Diagnosis of Cardiac Arrhythmias Compared Against Cardiac Electrophysiology Study.

Arrhythmia Atrial fibrillation Electrophysiology Single-lead ECG Ventricular tachycardia

Journal

Heart, lung & circulation
ISSN: 1444-2892
Titre abrégé: Heart Lung Circ
Pays: Australia
ID NLM: 100963739

Informations de publication

Date de publication:
05 Jul 2024
Historique:
received: 11 10 2023
revised: 25 03 2024
accepted: 18 05 2024
medline: 7 7 2024
pubmed: 7 7 2024
entrez: 6 7 2024
Statut: aheadofprint

Résumé

Single-lead electrocardiogram (ECG) devices may allow detection and diagnosis of cardiac rhythms. However, data on their accuracy for detecting cardiac arrhythmias beyond atrial fibrillation are limited. We aimed to determine the accuracy of the AliveCor KardiaMobile (AC) (AliveCor Inc, Mountain View, CA, USA) for the diagnosis of arrhythmias against gold standard cardiac electrophysiology study (EPS). Patients undergoing clinically indicated EPS underwent simultaneous rhythm recording with an AC, standard 12-lead ECG, and EP catheters for intracardiac electrograms. Rhythms recorded during EPS were classified based on electrogram, 12-lead ECG, and clinical findings. Blinded reviewers provided differential diagnoses for the single-lead AC tracings; a separate reviewer compared diagnoses made between the AC tracings and EPS findings. In 49 patients, 843 cardiac rhythms were captured during 502 AC recordings. Analysis of tracings containing sinus rhythm (n=273) returned an overall accuracy of 92%, with sensitivity and specificity values of 93% and 92%, respectively. Accuracy for tracings per rhythm was atrial fibrillation 91% (n=51); supraventricular tachycardia accuracy was 89% (n=191), ventricular tachycardia 91% (n=198), ventricular fibrillation 98% (n=11), and asystole 100% (n=5). Accuracy for supraventricular ectopy was 93% (n=28) and for premature ventricular complexes was 91% (n=86). Overall accuracy was 94% for solitary rhythms and 93% in tracings from patients with baseline bundle branch block. When compared against the gold standard EPS diagnosis, the interpretation of arrhythmias recorded by an AliveCor single-lead ECG device had reasonable diagnostic accuracy.

Sections du résumé

BACKGROUND BACKGROUND
Single-lead electrocardiogram (ECG) devices may allow detection and diagnosis of cardiac rhythms. However, data on their accuracy for detecting cardiac arrhythmias beyond atrial fibrillation are limited. We aimed to determine the accuracy of the AliveCor KardiaMobile (AC) (AliveCor Inc, Mountain View, CA, USA) for the diagnosis of arrhythmias against gold standard cardiac electrophysiology study (EPS).
METHOD METHODS
Patients undergoing clinically indicated EPS underwent simultaneous rhythm recording with an AC, standard 12-lead ECG, and EP catheters for intracardiac electrograms. Rhythms recorded during EPS were classified based on electrogram, 12-lead ECG, and clinical findings. Blinded reviewers provided differential diagnoses for the single-lead AC tracings; a separate reviewer compared diagnoses made between the AC tracings and EPS findings.
RESULTS RESULTS
In 49 patients, 843 cardiac rhythms were captured during 502 AC recordings. Analysis of tracings containing sinus rhythm (n=273) returned an overall accuracy of 92%, with sensitivity and specificity values of 93% and 92%, respectively. Accuracy for tracings per rhythm was atrial fibrillation 91% (n=51); supraventricular tachycardia accuracy was 89% (n=191), ventricular tachycardia 91% (n=198), ventricular fibrillation 98% (n=11), and asystole 100% (n=5). Accuracy for supraventricular ectopy was 93% (n=28) and for premature ventricular complexes was 91% (n=86). Overall accuracy was 94% for solitary rhythms and 93% in tracings from patients with baseline bundle branch block.
CONCLUSIONS CONCLUSIONS
When compared against the gold standard EPS diagnosis, the interpretation of arrhythmias recorded by an AliveCor single-lead ECG device had reasonable diagnostic accuracy.

Identifiants

DOI: 10.1016/j.hlc.2024.05.008 PMID: 38971645
pubmed: 38971645
pii: S1443-9506(24)00630-9
doi: 10.1016/j.hlc.2024.05.008
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Crown Copyright © 2024. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest No authors have financial interest in the KardiaMobile or distributor of the KardiaMobile. Dr Kumar has received funding and/or consulting fees from Abbott Medical, Biosense Webster, Biotronik and Medtronic, and has received honoraria from Abbott Medical, Biosense Webster, Biotronik, and Sanofi Aventis. Dr Mahajan has served on the advisory board of Abbott and Medtronic. The University of Adelaide reports receiving, on behalf of Dr Mahajan, research funding from Abbott, Bayer, and Medtronic, and lecture and/or consulting fees from Abbott, Bayer, Biotronik, Medtronic, and Pfizer. The remaining authors have nothing to disclose.

Auteurs

Samual Turnbull (S)

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.

Kartheek Garikapati (K)

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.

Richard G Bennett (RG)

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.

Timothy G Campbell (TG)

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.

Yasuhito Kotake (Y)

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.

Kasun De Silva (K)

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.

Rajiv Mahajan (R)

Department of Cardiology, Lyell McEwin Hospital, University of Adelaide, Adelaide, SA, Australia.

Mary S Wong (MS)

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.

Samia Kazi (S)

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.

Simone Marschner (S)

Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.

Karen Byth (K)

Westmead Research and Education Network, Westmead Hospital, Sydney, NSW, Australia.

Stuart P Thomas (SP)

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.

Clara K Chow (CK)

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.

Saurabh Kumar (S)

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia. Electronic address: saurabh.kumar@sydney.edu.au.

Classifications MeSH