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Multichannel Electrocardiograms Obtained by a Smartwatch for the Diagnosis of ST-Segment Changes
IMPORTANCE: Acute coronary syndromes are the leading cause of death worldwide and the leading cause of disease burden in high-income countries. Quick and accurate diagnosis of acute coronary syndromes is essential to avoid fatal events, for timely intervention, and to improve the prognosis. OBJECTIV...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Medical Association
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466842/ https://www.ncbi.nlm.nih.gov/pubmed/32865545 http://dx.doi.org/10.1001/jamacardio.2020.3994 |
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author | Spaccarotella, Carmen Anna Maria Polimeni, Alberto Migliarino, Serena Principe, Elisa Curcio, Antonio Mongiardo, Annalisa Sorrentino, Sabato De Rosa, Salvatore Indolfi, Ciro |
author_facet | Spaccarotella, Carmen Anna Maria Polimeni, Alberto Migliarino, Serena Principe, Elisa Curcio, Antonio Mongiardo, Annalisa Sorrentino, Sabato De Rosa, Salvatore Indolfi, Ciro |
author_sort | Spaccarotella, Carmen Anna Maria |
collection | PubMed |
description | IMPORTANCE: Acute coronary syndromes are the leading cause of death worldwide and the leading cause of disease burden in high-income countries. Quick and accurate diagnosis of acute coronary syndromes is essential to avoid fatal events, for timely intervention, and to improve the prognosis. OBJECTIVE: To prospectively investigate the feasibility and accuracy of a smartwatch in recording multiple electrocardiographic (ECG) leads and detecting ST-segment changes associated with acute coronary syndromes compared with a standard 12-lead ECG. DESIGN, SETTING, AND PARTICIPANTS: A commercially available smartwatch was used in 100 participants to obtain multiple-channel ECGs. The study was conducted from April 19, 2019, to January 23, 2020. Fifty-four patients with ST elevation myocardial infarction, 27 patients with non-ST elevation myocardial infarction, and 19 healthy individuals were included in the study. The watch was placed in different body positions to obtain 9 bipolar ECG tracings (corresponding to Einthoven leads I, II, and III and precordial leads V1-V6) that were compared with a simultaneous standard 12-lead ECG. MAIN OUTCOMES AND MEASURES: The concordance among the results of the smartwatch and standard ECG recordings was assessed using the Cohen κ coefficient and Bland-Altman analysis. RESULTS: Of the 100 participants in the study, 67 were men (67%); mean (SD) age was 61 (16) years. Agreement was found between the smartwatch and standard ECG for the identification of a normal ECG (Cohen κ coefficient, 0.90; 95% CI, 0.78-1.00), ST-segment elevation changes (Cohen κ coefficient, 0.88; 95% CI, 0.78-0.97), and non–ST-segment elevation changes (Cohen κ coefficient, 0.85; 95% CI, 0.74-0.96). In addition, the Bland-Altman analysis demonstrated agreement between the smartwatch and standard ECG to detect the amplitude of ST-segment changes (bias, −0.003; SD, 0.18; lower limit, −0.36; and upper limit, 0.36). Use of the smartwatch ECG for the diagnosis of normal ECG showed a sensitivity of 84% (95% CI, 60%-97%) and specificity of 100% (95% CI, 95%-100%); for ST elevation, sensitivity was 93% (95% CI, 82%-99%) and specificity was 95% (95% CI, 85%-99%); and for NSTE ECG alterations, sensitivity was 94% (95% CI, 81%-99%) and specificity was 92% (95% CI, 83%-97%). CONCLUSIONS AND RELEVANCE: The findings of this study suggest agreement between the multichannel smartwatch ECG and standard ECG for the identification of ST-segment changes in patients with acute coronary syndromes. |
format | Online Article Text |
id | pubmed-7466842 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | American Medical Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-74668422020-09-25 Multichannel Electrocardiograms Obtained by a Smartwatch for the Diagnosis of ST-Segment Changes Spaccarotella, Carmen Anna Maria Polimeni, Alberto Migliarino, Serena Principe, Elisa Curcio, Antonio Mongiardo, Annalisa Sorrentino, Sabato De Rosa, Salvatore Indolfi, Ciro JAMA Cardiol Brief Report IMPORTANCE: Acute coronary syndromes are the leading cause of death worldwide and the leading cause of disease burden in high-income countries. Quick and accurate diagnosis of acute coronary syndromes is essential to avoid fatal events, for timely intervention, and to improve the prognosis. OBJECTIVE: To prospectively investigate the feasibility and accuracy of a smartwatch in recording multiple electrocardiographic (ECG) leads and detecting ST-segment changes associated with acute coronary syndromes compared with a standard 12-lead ECG. DESIGN, SETTING, AND PARTICIPANTS: A commercially available smartwatch was used in 100 participants to obtain multiple-channel ECGs. The study was conducted from April 19, 2019, to January 23, 2020. Fifty-four patients with ST elevation myocardial infarction, 27 patients with non-ST elevation myocardial infarction, and 19 healthy individuals were included in the study. The watch was placed in different body positions to obtain 9 bipolar ECG tracings (corresponding to Einthoven leads I, II, and III and precordial leads V1-V6) that were compared with a simultaneous standard 12-lead ECG. MAIN OUTCOMES AND MEASURES: The concordance among the results of the smartwatch and standard ECG recordings was assessed using the Cohen κ coefficient and Bland-Altman analysis. RESULTS: Of the 100 participants in the study, 67 were men (67%); mean (SD) age was 61 (16) years. Agreement was found between the smartwatch and standard ECG for the identification of a normal ECG (Cohen κ coefficient, 0.90; 95% CI, 0.78-1.00), ST-segment elevation changes (Cohen κ coefficient, 0.88; 95% CI, 0.78-0.97), and non–ST-segment elevation changes (Cohen κ coefficient, 0.85; 95% CI, 0.74-0.96). In addition, the Bland-Altman analysis demonstrated agreement between the smartwatch and standard ECG to detect the amplitude of ST-segment changes (bias, −0.003; SD, 0.18; lower limit, −0.36; and upper limit, 0.36). Use of the smartwatch ECG for the diagnosis of normal ECG showed a sensitivity of 84% (95% CI, 60%-97%) and specificity of 100% (95% CI, 95%-100%); for ST elevation, sensitivity was 93% (95% CI, 82%-99%) and specificity was 95% (95% CI, 85%-99%); and for NSTE ECG alterations, sensitivity was 94% (95% CI, 81%-99%) and specificity was 92% (95% CI, 83%-97%). CONCLUSIONS AND RELEVANCE: The findings of this study suggest agreement between the multichannel smartwatch ECG and standard ECG for the identification of ST-segment changes in patients with acute coronary syndromes. American Medical Association 2020-10 2020-08-31 /pmc/articles/PMC7466842/ /pubmed/32865545 http://dx.doi.org/10.1001/jamacardio.2020.3994 Text en Copyright 2020 Spaccarotella CAM et al. JAMA Cardiology. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the CC-BY License. |
spellingShingle | Brief Report Spaccarotella, Carmen Anna Maria Polimeni, Alberto Migliarino, Serena Principe, Elisa Curcio, Antonio Mongiardo, Annalisa Sorrentino, Sabato De Rosa, Salvatore Indolfi, Ciro Multichannel Electrocardiograms Obtained by a Smartwatch for the Diagnosis of ST-Segment Changes |
title | Multichannel Electrocardiograms Obtained by a Smartwatch for the Diagnosis of ST-Segment Changes |
title_full | Multichannel Electrocardiograms Obtained by a Smartwatch for the Diagnosis of ST-Segment Changes |
title_fullStr | Multichannel Electrocardiograms Obtained by a Smartwatch for the Diagnosis of ST-Segment Changes |
title_full_unstemmed | Multichannel Electrocardiograms Obtained by a Smartwatch for the Diagnosis of ST-Segment Changes |
title_short | Multichannel Electrocardiograms Obtained by a Smartwatch for the Diagnosis of ST-Segment Changes |
title_sort | multichannel electrocardiograms obtained by a smartwatch for the diagnosis of st-segment changes |
topic | Brief Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466842/ https://www.ncbi.nlm.nih.gov/pubmed/32865545 http://dx.doi.org/10.1001/jamacardio.2020.3994 |
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