Slater Thomas A, Kimeu Redemptar, Jeilan Mohamed, Karaye Kamilu M, Mutagaywa Reuben K, Alfa Isiaka, Shidali Vincent Y, Gushi Emmanuel, Mwita Julius C, Mocheko Omphemetse, Allam Lamyaa, Ogah Okechukwu S, Ahmad Bashir G, Chin Ashley, Gopal Razeen, Durkin Philip, Bowes Robert, Leese Lucy, Ngantcha Marcus, Stegemann Berthold, Tayebjee Muzahir H
Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
Department of Cardiology, Aga Khan University Hospital, Nairobi, Kenya.
Heart Rhythm O2. 2025 Mar 17;6(5):687-695. doi: 10.1016/j.hroo.2025.03.009. eCollection 2025 May.
Handheld electrocardiograms (ECGs) can be used easily in remote centers at low cost and are therefore attractive options for rural, low-income settings. A modification to the Kardia 6L ECG has been developed to record chest leads V2 and V4 by placing the device electrodes in standard V2 and V4 position.
The study sought to validate this novel technique against the 12-lead ECG in a multicenter cohort from Africa and the United Kingdom to determine whether recordings are adequate for clinical use.
Adults >18 years of age who required an ECG as part of routine care were invited to participate. A 12-lead ECG was obtained followed by a 6-lead ECG using the Kardia 6L, then V2 and V4 chest lead equivalents were recorded. The primary endpoint was agreement between QT interval measurement in V2 and V4 on 12-lead ECG and Kardia 6L. Secondary endpoints assessed included rate, rhythm, PR interval, QRS duration, QRS amplitude, and ST-segment abnormalities.
A total of 1786 recordings were collected from 11 sites. Hypertension was the primary indication for ECG (28%). The coefficient of determination for QT interval in leads V2 and V4 was 0.59 and 0.61, respectively, within the prespecified limit of agreement. The adjusted R for multiple ECG parameters was >0.5, indicating satisfactory agreement.
Modified chest lead recordings using the Kardia 6L handheld ECG recorder compared well with gold standard 12-lead ECG recordings and provide a basis for future simulated 12-lead ECG recordings using the Kardia 6L. This could improve accessibility of high-quality ECG recording and interpretation in rural, low-income settings.
手持式心电图（ECG）可在偏远中心轻松使用，成本低廉，因此是农村低收入地区颇具吸引力的选择。已对Kardia 6L心电图进行了改进，通过将设备电极置于标准V2和V4位置来记录胸导联V2和V4。
本研究旨在针对来自非洲和英国的多中心队列，将这种新技术与12导联心电图进行验证，以确定记录是否足以用于临床。
邀请年龄>18岁且需要进行常规心电图检查的成年人参与。先进行12导联心电图检查，然后使用Kardia 6L进行6导联心电图检查，接着记录V2和V4胸导联等效值。主要终点是12导联心电图和Kardia 6L上V2和V4导联QT间期测量值之间的一致性。评估的次要终点包括心率、心律、PR间期、QRS时限、QRS波幅和ST段异常。
共从11个地点收集了1786份记录。高血压是心电图检查的主要指征（28%）。在预先设定的一致性限度内，V2和V4导联QT间期的决定系数分别为0.59和0.61。多个心电图参数的调整R值>0.5，表明一致性良好。
使用Kardia 6L手持式心电图记录仪进行的改良胸导联记录与金标准12导联心电图记录相比效果良好，为未来使用Kardia 6L模拟12导联心电图记录提供了基础。这可以提高农村低收入地区高质量心电图记录和解读的可及性。
