Non-conscious detection of ST-segment elevation during physician ECG interpretation

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology Pub Date : 2025-11-01 Epub Date: 2025-10-18 DOI:10.1016/j.jelectrocard.2025.154148

Gregory J. DiGirolamo Ph.D , Nikolaos Kakouros M.D , Federico Sorcini B.A , Sofia Patrizi Sorcini , Jenna Dupell , Erin K. Sands B.A , Max P. Rosen M.D

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引用次数: 0

Abstract

Objective

To investigate errors in the assessment of ST-elevation (STEs) myocardial infarctions on ECGs to determine if non-conscious processes successfully detect missed STEs, as evidenced by changes in how long and often physicians look at leads with STEs.

Materials and method

Eight experienced physicians interpreted 90 ECGs (45 STEs, 45 Normal) while eye movements were recorded. Physicians marked consciously recognized or considered STEs. No clinical context was provided.

Results

Physicians missed 18% of STEs. Eye-tracking showed longer (P = 0.02), more frequent (P = 0.02), and increased transitions (P = 0.02) to “missed” STE leads compared to Normal ECG leads.

Discussion

Non-conscious detection of STEs, including inter‑lead relationships, despite a lack of conscious recognition, suggests a sophisticated mechanism of wholistic detection, including culprit lesion sites by non-conscious processes.

Conclusion

Non-conscious detection of STEs supports non-conscious detection processing in medicine leading to more success than can be tracked by conscious report. Eye-tracking could enhance ECG interpretation and reduce diagnostic errors.

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医师心电图解读时st段抬高的无意识检测

目的研究心电图上st段抬高（STEs）心肌梗死评估的错误，以确定无意识过程是否成功检测到遗漏的STEs，这可以通过医生检查STEs导联的时间和频率的变化来证明。材料与方法8名经验丰富的医生对90例脑电图进行了判读，其中45例为脑电图，45例为正常脑电图，同时记录眼球运动。医生有意识地识别或认为是STEs。没有提供临床背景。结果内科医生漏诊率为18%。眼动追踪显示，与正常心电图导联相比，STE导联“遗漏”的时间更长（P = 0.02），频率更高（P = 0.02），过渡次数增加（P = 0.02）。无意识检测STEs，包括导联关系，尽管缺乏有意识的识别，表明一个复杂的整体检测机制，包括无意识过程的罪魁祸首病变部位。结论STEs的无意识检测支持医学上的无意识检测处理，其成功率高于有意识报告。眼动追踪可以增强心电解释，减少诊断错误。

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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来源期刊

Journal of electrocardiology 医学-心血管系统

CiteScore

2.70

自引率

7.70%

发文量

152

审稿时长

38 days

期刊介绍： The Journal of Electrocardiology is devoted exclusively to clinical and experimental studies of the electrical activities of the heart. It seeks to contribute significantly to the accuracy of diagnosis and prognosis and the effective treatment, prevention, or delay of heart disease. Editorial contents include electrocardiography, vectorcardiography, arrhythmias, membrane action potential, cardiac pacing, monitoring defibrillation, instrumentation, drug effects, and computer applications.