Validation of interpretation of ST-elevation myocardial infarction using the smartphone based 12 lead electrocardiograms in comparison to the cardiologist-a cross sectional study, validation study, single-center study
Keywords:ECG, STEMI/ STEMI, Smartphone, Validation
Background: In patients experiencing an ST-elevation myocardial infarction (STEMI), rapid diagnosis leads to optimal clinical outcomes. Recent technology has provided access to a reliable means of obtaining an ECG reading through a smartphone application (app) that works with an attachment providing all 12-leads of a standard ECG system. We developed a 12-lead smartphone-based electrocardiogram (ECG) called “Spandan”, and an application to accurately assess the presence of STEMI in patients presenting with chest pain. Objectives of study was to perform clinical observation studies on the patients screened for STEMIs and evaluate the variation in the diagnosis of STEMIs detected in both 12-lead gold standard and Spandan 12 lead ECG.
Methods: This single-center study was carried out at Shri Mahant Indresh hospital (SMIH), Dehradun, Uttarakhand, India from April-2022 to November-2022. All patients (n=278) visiting the ECG room with symptoms of chest pain, shortness of breath and past history of cardiovascular disease at the department of cardiology of the SMIH, Dehradun were included in the study.
Results: Mean age (SD) was 53.96±15.31 years. The male gender participants was 75.17%. 14.3% were STEMI patients as per the standard 12 lead interpretation, smartphone ECG interpreted 7.1% of the participants as STEMI and cardiologist interpreted nearly 15.4% of the participants of STEMI.
Conclusions: This study confirmed the potential of a smartphone ECG for evaluation of STEMI and the feasibility of studying this technology further to define the diagnostic accuracy, limitations, and appropriate use of this new technology.
Balbi MM, Scarparo P, Tovar MN, Masdjedi K, Daemen J, Den Dekker W et al. Culprit lesion detection in patients presenting with non-ST elevation acute coronary syndrome and multivessel disease. Cardiovascular Revascularization Med. 2022;35:110-8.
Zamani B, Golabchi A, Ghadakkar N, Motedayyen H. C-reactive protein and uric acid roles in distinguishing ST-segment elevation myocardial infarction from non-ST-elevation acute coronary syndrome. J Immunoassay Immunochem. 2023;44(1):66-75.
Kunkel KJ, Lemor A, Mahmood S, Villablanca P, Ramakrishna H. 2021 update for the diagnosis and Management of Acute Coronary Syndromes for the perioperative clinician. J Cardiothoracic Vascular Anesthesia 2022;36(8):2767-79.
Alavi MM, Diercks DB. Pathophysiology and Definition of the Acute Coronary Syndromes. Short Stay Management of Chest Pain. 2022: 61-68.
Yildiz BS, Cetin N, Gunduz R, Bilge A, Ozgur S, Orman MN. Effect of Coronary Thrombus Aspiration in Non ST Elevation Acute Coronary Syndrome Patients on Three-Year Survival-Does it add any Benefit? Angiology. 2022;00033197211053404.
Ahmed T, Honaker O, Misumida N, Messerli AW. Spontaneous Coronary Artery Dissection (SCAD) complicated with post-infarction ventricular septal rupture and a comparative review on mechanical complications related with SCAD. Curr Problems Cardiol. 2022;101229.
Dylla L, Rice JD, Poisson SN, Monte AA, Higgins HM, Ginde AA et al. Analysis of stroke care among 2019-2020 national emergency medical services information system encounters. J Stroke Cerebrovascular Dis. 2022;31(3):106278.
Maleczek M, Schebesta K, Hamp T, Burger AL, Pezawas T, Krammel M et al. ST-T segment changes in prehospital emergency physicians in the field: a prospective observational trial. Scandinavian J Trauma, Resuscitation Emergency Med. 2022;30(1):1-9.
Rizas KD, Freyer L, Sappler N, von Stülpnagel L, Spielbichler P, Krasniqi et.al. Smartphone-based screening for atrial fibrillation: a pragmatic randomized clinical trial. Nature Med. 2022;28(9):1823-30.
Cabra Lopez JL, Parra C, Gomez L, Trujillo L. Sex recognition through ECG signals aiming toward smartphone authentication. Applied Sci. 2022;12(13):6573.
Hermans AN, Gawalko M, Dohmen L, V6an der Velden RM, Betz K, Duncker D et al. Mobile health solutions for atrial fibrillation detection and management: a systematic review. Clin Res Cardiol. 2022;111(5):479-91.
Moya-Ramon M, Mateo-March M, Peña-González I, Zabala M, Javaloyes A. Validity and reliability of different smartphones applications to measure HRV during short and ultra-short measurements in elite athletes. Computer Methods Programs Biomed. 2022;217:106696.
El Hussein MT, Habib J. CHEST: Mnemonic approach to manage pulmonary embolism. Nurse Practitioner 2022;47(8):22-30.
Wegner FK, Eckardt L. Smartphone-based ECG devices: Beyond atrial fibrillation screening. Eur J Internal Med. 2022;95:111-2.
Emmett A, Kent B, James A, March‐McDonald J. Experiences of health professionals towards using mobile electrocardiogram (ECG) technology: A qualitative systematic review. J Clin Nurs. 2022.
Kuznetsova N, Gubina A, Sagirova Z, Dhif I, Gognieva D, Melnichuk A et al. Left Ventricular Diastolic Dysfunction Screening by a Smartphone-Case Based on Single Lead ECG. Clin Med Insights: Cardiol. 2022;11795468221120088.
Gill S, Bunting KV, Sartini C, Cardoso VR, Ghoreishi N, Uh HW, et al. Smartphone detection of atrial fibrillation using photoplethysmography: a systematic review and meta-analysis. Heart. 2022;108(20):1600-7.
Bonini N, Vitolo M, Imberti JF, Proietti M, Romiti GF, Boriani G et al. Mobile health technology in atrial fibrillation. Expert Rev Med Devices. 2022;19(4):327-40.
Barbagelata A, Bethea CF, Severance HW, Mentz RJ, Albert D, Barsness GW et al. Smartphone ECG for evaluation of ST-segment elevation myocardial infarction (STEMI): design of the ST LEUIS International Multicenter Study. J Electrocardiol. 2018;51(2):260-4.
Orchard J, Freedman SB, Lowres N, Peiris D, Neubeck L. iPhone ECG screening by practice nurses and receptionists for atrial fibrillation in general practice: the GP-SEARCH qualitative pilot study. Austr Family Physician. 2014;43(5):315-9.