1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.
Cardiol J. 2021;28(4):543-548. doi: 10.5603/CJ.a2019.0001. Epub 2019 Jan 15.
Mobile devices are gaining a rising number of users in all countries around the globe. Novel solutions to diagnose patients with out-of-hospital onset of arrhythmic symptoms can be easily used to record such events, but the effectiveness of these devices remain unknown.
In a group of 100 consecutive patients of an academic cardiology care center (mean age 68 ± 14.2 years, males: 66%) a standard 12-lead electrocardiogram (ECG) and a Kardia Mobile (KM) record were registered. Both versions were assessed by three independant groups of physicians.
The analysis of comparisons for standard ECG and KM records showed that the latter is of lower quality (p < 0.001). It was non-inferior for detection of atrial fibrillation and atrial flutter, showed weaker rhythm detection in pacemaker stimulation (p = 0.008), and was superior in sinus rhythm detection (p = 0.02), though. The sensitivity of KM to detect pathological Q-wave was low compared to specificity (20.6% vs. 93.7%, respectively, p < 0.001). Basic intervals measured by the KM device, namely PQ, RR, and QT were significantly different (shorter) than those observed in the standard ECG method (160 ms vs. 180 ms [p < 0.001], 853 ms vs. 880 ms [p = 0.03] and 393 ms vs. 400 ms [p < 0.001], respectively).
Initial and indicative value of atrial fibrillation and atrial flutter detection in KM is comparable to results achieved in standard ECG. KM was superior in detection of sinus rhythm than eye-ball evaluation of 12-lead ECG. Though, the PQ and QT intervals were shorter in KM as compared to 12-lead ECG. Clinical value needs to be verified in large studies, though.
移动设备在全球各国的用户数量不断增加。新型解决方案可用于诊断院外发作的心律失常症状患者,方便记录此类事件,但这些设备的效果尚不清楚。
在一个学术心脏病护理中心的 100 名连续患者(平均年龄 68 ± 14.2 岁,男性 66%)中,同时记录标准 12 导联心电图(ECG)和 Kardia Mobile(KM)记录。由三组独立的医生评估这两种版本。
对标准 ECG 和 KM 记录的分析比较表明,后者质量较低(p < 0.001)。在检测心房颤动和心房扑动方面具有非劣效性,在起搏器刺激时的节律检测较弱(p = 0.008),在窦性节律检测方面具有优势(p = 0.02)。与特异性相比,KM 检测病理性 Q 波的敏感性较低(分别为 20.6%和 93.7%,p < 0.001)。KM 设备测量的基本间隔,即 PQ、RR 和 QT 明显短于标准 ECG 方法(160 ms 比 180 ms [p < 0.001],853 ms 比 880 ms [p = 0.03]和 393 ms 比 400 ms [p < 0.001])。
KM 在检测心房颤动和心房扑动方面的初始和指示价值与标准 ECG 相当。KM 在检测窦性节律方面优于 12 导联 ECG 的眼球评估。尽管如此,与 12 导联 ECG 相比,KM 的 PQ 和 QT 间隔较短。但仍需要在大规模研究中验证其临床价值。