Accuracy of a Single-Lead ECG Device for Diagnosis of Cardiac Arrhythmias Compared Against Cardiac Electrophysiology Study - 05/07/24

Doi : 10.1016/j.hlc.2024.05.008

Samual Turnbull, BSc ^a,^b,^{^{1
Contributed equally to this work.}}, Kartheek Garikapati, MBBS ^a,^b,^{^{1
Contributed equally to this work.}}, Richard G. Bennett, MBChB, PhD ^a,^b, Timothy G. Campbell, PhD ^a,^b, Yasuhito Kotake, MD, PhD ^a,^b, Kasun De Silva, MD ^a,^b, Rajiv Mahajan, MBBS, PhD ^c, Mary S. Wong, PhD ^a,^b, Samia Kazi, MBBS ^a,^b, Simone Marschner, MSc ^b, Karen Byth, PhD ^d, Stuart P. Thomas, BMed, PhD ^a,^b, Clara K. Chow, MBBS, PhD ^a,^b, Saurabh Kumar, BSc (Med)/MBBS, PhD ^a,^b,^⁎
^a Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia
^b Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia
^c Department of Cardiology, Lyell McEwin Hospital, University of Adelaide, Adelaide, SA, Australia
^d Westmead Research and Education Network, Westmead Hospital, Sydney, NSW, Australia

^∗Corresponding author at: Cardiology Department, Westmead Hospital, Corner of Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia.Cardiology DepartmentWestmead HospitalCorner of Hawkesbury and Darcy RoadsWestmeadNSW2145Australia

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 05 July 2024

Abstract

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

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

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

When compared against the gold standard EPS diagnosis, the interpretation of arrhythmias recorded by an AliveCor single-lead ECG device had reasonable diagnostic accuracy.

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Keywords : Arrhythmia, Single-lead ECG, Ventricular tachycardia, Atrial fibrillation, Electrophysiology