Langanke Alexander, Reifart Nicolaus, Reifart Joerg
Kliniken des Main Taunus Kreises, Medizinische Klinik 1, Kronberger Straße 36, 65812 Bad Soden, Germany.
Kardiologische Praxis Reifart und Partner, Kronberger Straße 36, 65812 Bad Soden, Germany; Petrus-Krankenhaus, Department of Cardiology, Carnaper Str. 48, 42283 Wuppertal, Germany.
J Electrocardiol. 2021 Nov-Dec;69:74-81. doi: 10.1016/j.jelectrocard.2021.09.013. Epub 2021 Sep 25.
The use of mobile devices for electrocardiogram (ECG) recording and the ability to use this technology to immediately review dynamic waveforms is growing tremendously. While over-the-counter ECG devices may display rhythm disorders and ST-segment changes at rest, changes during physical exercise have thus far not been evaluated. We compared a mobile device (smartphone/tablet)-enabled vectorial 4-electrode ECG system (SPE) with the current standard 12‑lead (STE) ECG both at rest and during exercise.
A total of 428 patients underwent simultaneous ECG testing with both technologies during rest and maximal exercise. The vectorial ECG was displayed as 12‑lead ECG, and diagnostic accuracy and ECG quality (independently judged by blinded cardiologists) were compared with the current standard. Signal quality was good with both ECG technologies. At rest, there was excellent agreement between SPE and STE regarding rhythm (98%), AV-conduction (97%), wave duration (90%), and electrical axis (88-97%). During exercise the presence or absence of ST-deviation (>0.1 mm) corresponded in 90% of cases with no statistically significant difference. The positive predictive value was 48.5% and the negative predictive value was 94%. For ST-deviations >0.2 mm the percentage match was 97% during exercise. For rhythm disorders and for intraventricular conduction (left- and right-bundle branch block detection) it was >90%.
A smart-device-enabled vectorial ECGs system using the CardioSecur system can be used in daily practice to reliably interpret an ECG at rest and during physical exercise, although it is less accurate with respect to the detection of ST-deviation.
使用移动设备进行心电图（ECG）记录以及利用该技术立即查看动态波形的能力正在迅猛发展。虽然非处方ECG设备可能显示静息时的节律紊乱和ST段变化，但迄今为止尚未评估体育锻炼期间的变化。我们比较了一种启用移动设备（智能手机/平板电脑）的矢量4电极ECG系统（SPE）与当前标准的12导联（STE）ECG在静息和运动期间的情况。
共有428例患者在静息和最大运动期间同时使用这两种技术进行ECG测试。矢量ECG显示为12导联ECG，并将诊断准确性和ECG质量（由不知情的心脏病专家独立判断）与当前标准进行比较。两种ECG技术的信号质量都很好。静息时，SPE和STE在节律（98%）、房室传导（97%）、波持续时间（90%）和电轴（88 - 97%）方面具有极好的一致性。运动期间，ST段偏移（>0.1 mm）的有无在90%的病例中相符，无统计学显著差异。阳性预测值为48.5%，阴性预测值为94%。对于>0.2 mm的ST段偏移，运动期间的匹配百分比为97%。对于节律紊乱和室内传导（左、右束支传导阻滞检测），匹配率>90%。
使用CardioSecur系统的启用智能设备的矢量ECG系统可用于日常实践，以可靠地解读静息和体育锻炼期间的ECG，尽管在检测ST段偏移方面准确性较低。
