Detection of Acute Coronary Occlusion with A Novel Mobile ECG Device: A Pilot Study

Alejandra Zepeda-Echavarria, R. R. van de Leur, Melle Vessies, Nynke M. de Vries, Meike van Sleuwen, R. Hassink, T. Wildbergh, J. L. van Doorn, Rien van der Zee, Pieter A. Doevendans, J. Jaspers, R. van Es
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Abstract

Many portable ECG devices have been developed to monitor patients at home, but the majority of these devices are single lead, and only intended for rhythm disorders. We developed the miniECG, a smartphone sized portable device with four dry electrodes capable of recording a high-quality multi-lead ECG by placing the device on the chest. The aim of our study was to investigate the ability of the miniECG to detect occlusive myocardial infarction (OMI) in patients with chest pain. Patients presenting with acute chest pain at the emergency department of the University Medical Center Utrecht or Meander Medical Center, between May 2021 and February 2022 were included in the study. The clinical 12-lead ECG and the miniECG before coronary intervention were recorded. The recordings were evaluated by cardiologists and compared the outcome of the coronary angiography, if performed. A total of 369 patients were measured with the miniECG, 46 of whom had OMI. The miniECG detected OMI with a sensitivity and specificity of 65% and 92%, compared to 83% and 90% for the 12-lead ECG. Sensitivity of the miniECG was similar for different culprit vessels. The miniECG can record a multi-lead ECG and rule-in ST-segment deviation in patients with occluded or near occluded coronary arteries from different culprit vessels without many false alarms. Further research is required to add automated analysis to the recordings and to show feasibility to use the miniECG by patients at home.
使用新型移动心电图设备检测急性冠状动脉闭塞:试点研究
目前已开发出许多便携式心电图设备,用于在家中对患者进行监测,但这些设备大多是单导联的,只能用于心律失常。我们开发了 miniECG,这是一种智能手机大小的便携式设备,带有四个干电极,只需将设备放在胸前就能记录高质量的多导联心电图。 我们的研究目的是调查 miniECG 检测胸痛患者闭塞性心肌梗死(OMI)的能力。 研究对象包括 2021 年 5 月至 2022 年 2 月期间在乌得勒支大学医学中心或 Meander 医学中心急诊科就诊的急性胸痛患者。研究人员记录了冠状动脉介入治疗前的临床 12 导联心电图和迷你心电图。记录由心脏病专家进行评估,并与冠状动脉造影(如果进行)的结果进行比较。 共对 369 名患者进行了迷你心电图测量,其中 46 人患有 OMI。微型心电图检测 OMI 的灵敏度和特异性分别为 65% 和 92%,而 12 导联心电图的灵敏度和特异性分别为 83% 和 90%。微型心电图对不同罪魁祸首血管的灵敏度相似。 迷你电子心电图可记录多导联心电图,并可排除来自不同罪魁祸首血管的冠状动脉闭塞或接近闭塞患者的 ST 段偏差,而不会出现大量误报。还需要进一步研究,以增加对记录的自动分析,并证明患者在家中使用微型心电图仪的可行性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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