Evaluation of ST-segment agreement between Spandan Pro and gold standard electrocardiogram for percutaneous coronary intervention decision-making.

Abstract

Background: ST-elevation myocardial infarction (STEMI) is a critical condition requiring rapid diagnosis and treatment. Smartphone-based Electrocardiogram (ECG) devices, like Spandan Pro, offer the potential for timely Percutaneous Coronary Intervention (PCI) in STEMI patients, particularly in resource-limited environments.

Objective: To assess the agreement between ST-segment elevation measurements obtained from the Spandan Pro ECG device and those from a Gold standard ECG (BPL Cardiart), using Bland-Altman (BA) analysis, in the context of decision-making for PCI.

Methods: A cross-sectional, observational study was conducted on 200 patients who presented to the local Hospital with complaints of chest pain. After strict application of exclusion criteria, a total of 184 patients were assessed in the study. BA analysis has been used to estimate the agreement between ST-segment elevation measurements obtained from the Spandan Pro ECG device with the Gold standard ECG. The ECG reports assist the cardiologist in making decisions regarding PCI.

Results: Of the 184 patients, 55 met the criteria for PCI, 33 of whom presented within 120 h of symptom onset. BA analysis revealed that the mean differences between the two methods were clinically insignificant, with agreement limits falling within acceptable ranges across all leads, confirming the reliability of the Spandan Pro.

Conclusion: The Spandan Pro ECG device shows good agreement in diagnosing ST elevation with the Gold standard ECG, making it a valuable tool in decision-making regarding PCI by the cardiologist. It also improves patient outcomes by enabling rapid diagnosis and treatment, especially in resource-limited or prehospital environments.