Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.
Department of Cardiology, Lyell McEwin Hospital, University of Adelaide, Adelaide, SA, Australia.
Heart Lung Circ. 2024 Oct;33(10):1465-1474. doi: 10.1016/j.hlc.2024.05.008. Epub 2024 Jul 8.
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).
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.
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.
When compared against the gold standard EPS diagnosis, the interpretation of arrhythmias recorded by an AliveCor single-lead ECG device had reasonable diagnostic accuracy.
单导联心电图（ECG）设备可用于检测和诊断心脏节律。然而，关于其在检测除房颤以外的心律失常方面的准确性的数据有限。我们旨在确定AliveCor KardiaMobile（AC）（AliveCor Inc，加利福尼亚州山景城）用于诊断心律失常的准确性，将其与金标准心脏电生理研究（EPS）进行对比。
接受临床指征明确的 EPS 的患者同时使用 AC、标准 12 导联 ECG 和 EP 导管进行心内电图记录。根据电描记图、12 导联 ECG 和临床发现对 EPS 期间记录的节律进行分类。盲法审阅者为单导联 AC 描记图提供鉴别诊断；另一位审阅者比较了 AC 描记图和 EPS 结果之间的诊断。
在 49 名患者中，在 502 次 AC 记录中捕获了 843 个心脏节律。对包含窦性节律（n=273）的描记进行分析，总体准确率为 92%，敏感性和特异性值分别为 93%和 92%。每个节律的描记准确率为房颤 91%（n=51）；室上性心动过速准确率为 89%（n=191），室性心动过速准确率为 91%（n=198），心室颤动准确率为 98%（n=11），心搏停止准确率为 100%（n=5）。室上性异位搏动的准确率为 93%（n=28），室性期前收缩的准确率为 91%（n=86）。孤立节律的总体准确率为 94%，伴有基线束支传导阻滞的患者的描记准确率为 93%。
与金标准 EPS 诊断相比，AliveCor 单导联 ECG 设备记录的心律失常的解释具有合理的诊断准确性。
