Karunadas Chakkalakkal Prabhakaran, Mathew Cibu
Department of Cardiology, Government Medical College, Thrissur, Kerala, 680596, India.
Indian Pacing Electrophysiol J. 2020 Mar-Apr;20(2):49-53. doi: 10.1016/j.ipej.2019.12.013. Epub 2019 Dec 19.
Ambulatory electrocardiogram (AECG) is done for evaluation of arrhythmia. Commonly used AECG system is 24 h Holter. Patch based second generation AECG monitoring devices, which can record for longer periods, are now available.
Android App based WebCardio using WiPatch is a new AECG system which records ECG in two leads for 72 h. Our study compared the arrhythmia detection by WebCardio and conventional Holter by simultaneously connecting both for 24 h in patients having indication for AECG.
The AECG of patients who had simultaneous recording with WebCardio and conventional Holter, in the department of Cardiology, Medical College, Thrissur were evaluated. Ability to detect any of the 6 arrhythmias :1) atrial fibrillation (AF), 2) atrioventricular (AV) block, 3) sinus pause of ≥3 s (SP), 4) supraventricular tachycardia (SVT), 5) premature ventricular complex (PVC) and 6) ventricular tachycardia (VT)/ventricular fibrillation (VF) was compared. Detection of each arrhythmia was also compared.
141 patients had simultaneous recordings by both systems of AECG. The WebCardio picked up at least one of the 6 arrhythmias; AF, AV block, SP, SVT, PVC or VT/VF in 98 cases compared to 88 in the Holter (McNemars test, two tail P = 0.006). In eleven cases WebCardio detected an arrhythmia where Holter could not. In one case Holter identified an arrhythmia and WebCardio could not. Individual arrhythmias; AF, SP, SVT and VT/VF were detected equally by both systems. AV block (23 Vs 18, p = 0.0625) and PVCs (83 Vs 74, p = 0.0636) were detected in more number of cases in WebCardio. In the five cases where WebCardio alone identified AV block, four had poor quality of P wave in the Holter.
Arrhythmia was picked up in more number of patients by the WebCardio compared to Holter. This was due to higher pickup of AV block and PVCs by WebCardio. Difference in AV block identification was due to better quality of P in WebCardio. WebCardio is a good alternative to Holter for AECG.
动态心电图（AECG）用于评估心律失常。常用的AECG系统是24小时动态心电图监测仪。现在已有基于贴片的第二代AECG监测设备，其可记录更长时间。
基于安卓应用程序的使用WiPatch的WebCardio是一种新的AECG系统，可记录双导联心电图72小时。我们的研究通过在有AECG指征的患者中同时连接WebCardio和传统动态心电图监测仪24小时，比较了WebCardio和传统动态心电图监测仪对心律失常的检测情况。
对在特里苏尔医学院心脏病科同时使用WebCardio和传统动态心电图监测仪进行记录的患者的AECG进行评估。比较检测6种心律失常中任何一种的能力：1）心房颤动（AF）、2）房室（AV）传导阻滞、3）≥3秒的窦性停搏（SP）、4）室上性心动过速（SVT）、5）室性早搏（PVC）和6）室性心动过速（VT）/心室颤动（VF）。还比较了每种心律失常的检测情况。
141例患者同时使用两种AECG系统进行记录。WebCardio检测到6种心律失常中的至少一种；AF、AV传导阻滞、SP、SVT、PVC或VT/VF的有98例，而传统动态心电图监测仪检测到的有88例（McNemars检验，双侧P = 0.006）。在11例中，WebCardio检测到一种传统动态心电图监测仪未检测到的心律失常。在1例中，传统动态心电图监测仪识别出一种心律失常而WebCardio未检测到。对于个别心律失常；AF、SP、SVT和VT/VF两种系统检测情况相同。WebCardio检测到更多例AV传导阻滞（23例对18例，p = 0.0625）和PVC（83例对74例，p = 0.0636）。在仅WebCardio识别出AV传导阻滞的5例中；传统动态心电图监测仪中有4例P波质量差。
与传统动态心电图监测仪相比，WebCardio检测到心律失常的患者更多。这是由于WebCardio对AV传导阻滞和PVC的检出率更高。AV传导阻滞识别的差异是由于WebCardio中P波质量更好。对于AECG，WebCardio是传统动态心电图监测仪的一个很好的替代选择。
