Krzowski Bartosz, Skoczylas Kamila, Osak Gabriela, Żurawska Natalia, Peller Michał, Kołtowski Łukasz, Zych Aleksandra, Główczyńska Renata, Lodziński Piotr, Grabowski Marcin, Opolski Grzegorz, Balsam Paweł
1st Department of Cardiology, Medical University of Warsaw, Banacha 1a Street, 02-097 Warsaw, Poland.
Eur Heart J Digit Health. 2021 May 12;2(3):467-476. doi: 10.1093/ehjdh/ztab040. eCollection 2021 Sep.
Mobile, portable ECG-recorders allow the assessment of heart rhythm in out-of-hospital conditions and may prove useful for monitoring patients with cardiovascular diseases. However, the effectiveness of these portable devices has not been tested in everyday practice.
A group of 98 consecutive cardiology patients [62 males (63%), mean age 69 ± 12.9 years] were included in an academic care centre. For each patient, a standard 12-lead electrocardiogram (SE), as well as a Kardia Mobile 6L (KM) and Istel (IS) HR-2000 ECG were performed. Two groups of experienced physicians analysed obtained recordings. After analysing ECG tracings from SE, KM, and IS, quality was marked as good in 82%, 80%, and 72% of patients, respectively ( < 0.001). There were no significant differences between devices in terms of detecting sinus rhythm [SE (60%, = 59), KM (58%, = 56), and IS (61%, = 60); SE vs. KM = 0.53; SE vs. IS = 0.76) and atrial fibrillation [SE (22%, = 22), KM (22%, = 21), and IS (18%, = 18); (SE vs. KM = 0.65; SE vs. IS = 0.1)]. KM had a sensitivity of 88.1% and a specificity of 89.7% for diagnosing sinus rhythm. IS showed 91.5% and 84.6% sensitivity and specificity, respectively. The sensitivity of KM in detecting atrial fibrillation was higher than IS (86.4% vs. 77.3%), but their specificity was comparable (97.4% vs. 98.7%).
Novel, portable devices are useful in showing sinus rhythm and detecting atrial fibrillation in clinical practice. However, ECG measurements concerning conduction and repolarization should be clarified with a standard 12-lead electrocardiogram.
移动、便携式心电图记录仪可在院外条件下评估心律，可能对心血管疾病患者的监测有用。然而，这些便携式设备的有效性尚未在日常实践中得到检验。
在一个学术护理中心纳入了一组98例连续的心脏病患者[62例男性（63%），平均年龄69±12.9岁]。对每位患者进行了标准12导联心电图（SE）以及Kardia Mobile 6L（KM）和Istel（IS）HR - 2000心电图检查。两组经验丰富的医生分析了获得的记录。在分析了SE、KM和IS的心电图描记后，分别有82%、80%和72%的患者的心电图质量被标记为良好（<0.001）。在检测窦性心律方面，各设备之间无显著差异[SE（60%，n = 59），KM（58%，n = 56），IS（61%，n = 60）；SE与KM相比P = 0.53；SE与IS相比P = 0.76]以及心房颤动方面[SE（22%，n = 22），KM（22%，n = 21），IS（18%，n = 18）；（SE与KM相比P = 0.65；SE与IS相比P = 0.1）]。KM诊断窦性心律的敏感性为88.1%，特异性为89.7%。IS的敏感性和特异性分别为91.5%和84.6%。KM检测心房颤动的敏感性高于IS（86.4%对77.3%），但其特异性相当（97.4%对98.7%）。
新型便携式设备在临床实践中对于显示窦性心律和检测心房颤动是有用的。然而，关于传导和复极化的心电图测量应通过标准12导联心电图加以明确。
