Prospective, multicentre validation of a simple, patient-operated electrocardiographic system for the detection of arrhythmias and electrocardiographic changes
Open Access
- 24 September 2009
- journal article
- research article
- Published by Oxford University Press (OUP) in EP Europace
- Vol. 11 (10), 1362-1368
- https://doi.org/10.1093/europace/eup262
Abstract
Electrocardiographic changes, e.g. arrhythmias causing syncope or palpitations, are often transient and therefore difficult to diagnose. Systematic and symptom-activated ECG recordings can increase diagnostic yield in such patients. We evaluated the diagnostic accuracy of a simple, leadless, patient-operated ECG device compared with a standard 12-lead ECG. We recorded a standard 12-lead surface ECG and a patient-activated ECG in direct succession in 508 consecutive patients enrolled in four centres. All ECGs were analysed by a single, blinded observer. ECGs were analysable in 505 (99.4%) patients (66% male, age 61 ± 15 years, and body mass index 27 ± 4). Analysis of the patient-activated ECG adequately detected a normal ECG (sensitivity 91% and specificity 95%), atrial fibrillation (AF) (sensitivity 99% and specificity 96%), and even T-wave abnormalities (sensitivity 90% and specificity 75%). Diagnostic accuracy for atrioventricular nodal block was moderate (sensitivity 79% and specificity 99%). Continuous parameters correlated well: ( r2 = 0.89 for heart rate, 0.83 for PR interval, 0.78 for QRS duration, and 0.89 for QTc). Recordings made by this patient-operated ECG device allow to detect arrhythmias and other ECG changes with high accuracy compared with a standard ECG. It may help to improve accurate diagnosis of transient ECG changes such as paroxysmal AF in palpitations or other unexplained cardiac symptoms.Keywords
This publication has 22 references indexed in Scilit:
- Holter monitoring for syncope: diagnostic yield in different patient groups and impact on device implantationQJM: An International Journal of Medicine, 2007
- Outcome parameters for trials in atrial fibrillation: Recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NETwork and the European Heart Rhythm AssociationEP Europace, 2007
- Utility of Mobile Cardiac Outpatient Telemetry for the Diagnosis of Palpitations, Presyncope, Syncope, and the Assessment of Therapy EfficacyJournal of Cardiovascular Electrophysiology, 2007
- ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm SocietyEP Europace, 2006
- Diagnostic yield of patient-activated loop recorders for detecting heart rhythm abnormalities in general practice: a randomised clinical trialFamily Practice, 2005
- Atrial fibrillation in patients with first‐ever stroke: frequency, antithrombotic treatment before the event and effect on clinical outcomeJournal of Thrombosis and Haemostasis, 2005
- Asymptomatic atrial fibrillation: Demographic features and prognostic information from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) studyAmerican Heart Journal, 2005
- Prevention of atrial fibrillation after cardioversion: results of the PAFAC trialPublished by Oxford University Press (OUP) ,2004
- Suppression of paroxysmal atrial tachyarrhythmias ? results of the SOPAT trialEuropean Heart Journal, 2004
- Poor Outcome After First-Ever StrokeStroke, 2003